Quantification of non-reducing end glycan residual compounds for determining the presence, identity, or severity of a disease or condition

ABSTRACT

Provided herein are methods of diagnosing or monitoring the treatment of abnormal glycan accumulation or a disorder associated with abnormal glycan accumulation.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.13/550,106, filed Jul. 16, 2012 (now U.S. Pat. No. 8,771,974), which isa continuation of U.S. patent application Ser. No. 12/649,110, filedDec. 29, 2009 (now U.S. Pat. No. 8,232,073), which claims the benefit ofU.S. Provisional Application No. 61/142,291, filed Jan. 2, 2009, U.S.Provisional Application No. 61/164,365, filed Mar. 27, 2009, and U.S.Provisional Application No. 61/238,079, filed Aug. 28, 2009, each ofwhich are incorporated herein by reference.

BACKGROUND OF THE INVENTION

Many human diseases are caused by or correlated with changes inglycosylation. In order to use these changes as biomarkers of disease,analytical methods are used to quantify the changes. The publishedmethods use antibodies, chromatography and/or mass spectrometrytechniques to resolve and quantify the intact or partially intactglycans. These methods are challenging due to the complexity and numberof possible glycan structures present in biological samples. In a singledisease state there can be thousands of different novel glycanstructures that are present; however, each on their own is a weak markerof disease.

SUMMARY OF THE INVENTION

Described herein are populations of glycans that are transformed intopopulations of biomarkers using glycan degradation enzymes. Furtherdescribed herein are the use of analytical instruments to characterizethe population of biomakers (i.e., non-reducing end glycan residualcompounds, such as monosaccharides) in order to provide relevantinformation about the population of biomarkers, the population ofbiomarkers and the biological sample that provided the population ofbiomarkers.

Provided in certain embodiments herein are methods of detecting glycanaccumulation and/or abnormal glycan biosynthesis and/or degradation in abiological sample, the method comprising:

-   -   a. transforming a glycan of a biological sample with a glycan        degradation enzyme to liberate a glycan residual compound from        the non-reducing end of the glycan;    -   b. measuring the amount of the glycan residual compound        liberated by the functioning glycan degradation enzyme with an        analytical device.

In some embodiments, a method described herein comprises a method ofdiagnosing an individual as having a disease or condition associatedwith abnormal glycan biosynthesis, degradation, or accumulation, themethod comprising:

-   -   a. generating a biomarker comprising of one or more non-reducing        end glycan residual compound, wherein the biomarker is generated        by treating a population of glycans, in or isolated from a        biological sample from the individual, with at least one        digesting glycan enzymes, wherein prior to enzyme treatment, the        biomarker is not present in abundance in samples from        individuals with the disease or condition relative to        individuals without the disease or condition, and    -   b. using an analytical instrument to detect the presence of        and/or measure the amount of the biomarker produced and        displaying or recording the presence of or a measure of a        population of the biomarker;

In some embodiments, the presence of and/or measure the amount of thebiomarker is utilized to determine the presence, identity, and/orseverity of the disease or condition.

Provided in certain embodiments herein is a method of diagnosing anindividual as having a disease or condition associated with abnormalglycan biosynthesis, degradation, or accumulation, the methodcomprising:

-   -   a. transforming a glycan of a biological sample with a glycan        degradation enzyme to liberate a glycan residual compound from        the non-reducing end of the glycan;    -   b. measuring the amount of the glycan residual compound        liberated by the functioning glycan degradation enzyme with an        analytical device; and    -   c. determining whether the amount of liberated glycan residue is        abnormal.

In some embodiments, provided herein is a method of monitoring thetreatment of a disorder associated with the abnormal degradation,biosynthesis and/or accumulation of glycans, the method comprising:

-   -   a. following administration of an agent for treating a disorder        associated with the abnormal degradation, biosynthesis and/or        accumulation of glycans to an individual in need thereof, using        an analytical instrument to measure the amount of a population        of a biomarker comprising a non-reducing end glycan residual        compounds present in a transformed biological sample, the        biomarker being generated by treating a population of glycans,        in or isolated from a biological sample from the individual,        with at least one digesting glycan enzyme(s), wherein prior to        enzyme treatment, the biomarker is not present in abundance in        samples from individuals with the disease or condition relative        to individuals without the disease or condition, and    -   b. determining whether or not the amount of the amount of        biomarker has decreased or increased at a slower rate compared        to the amount or rate of increase prior to administration of the        agent for treating a disorder associated with the abnormal        degradation, biosynthesis and/or accumulation of glycans.

In some embodiments, the abnormal glycan accumulation or disorderassociated therewith is caused by an abnormally functioning glycandegradation enzyme and wherein the abnormally functioning glycandegradation enzyme and glycan degradation enzyme are of the same type(e.g., the glycan degradation utilized in the transformation process isa functioning glycan degradation enzyme whereas the abnormallyfunctioning enzyme is not, such as due to deletions, insertions,substitutions, or other modifications to the enzyme sequence). Incertain embodiments, the abnormally functioning glycan degradationenzyme functions abnormally as a result of being present in anabnormally low amount, functioning improperly, or a combination thereof.In some embodiments, the abnormal glycan accumulation comprises theaccumulation of abnormal amounts of glycans. In certain embodiments, theabnormal glycan accumulation comprises the accumulation of abnormalamounts of normal glycans. In some embodiments, the abnormal glycanaccumulation comprises the accumulation of abnormal amounts of abnormalglycans.

In certain embodiments, the biomarker is not present in the originalbiological sample. In some embodiments, the biomarker is not present inthe biological sample after isolating a population of glycans therefrom(e.g., prior to transformation of the glycan according to a processdescribed herein).

In certain embodiments, the normally functioning glycan degradationenzyme is a glycosidase, sulfatase, phosphorylase, deacetylase or acombination thereof. In some embodiments, the normally functioningglycan degradation enzyme is a glycosidase selected from anexo-glycosidase and an endo-glycosidase. In certain embodiments, theglycosidase is an exo-glycosidase selected from the group consisting ofa galactosidase, and a glucuronidase. In some embodiments, the generatedbiomarker is a glycan residual compound. In some embodiments, the glycanresidual compound is a monosaccharide. In certain embodiments, theglycan residual compound is sulfate, phosphate, acetate, or acombination thereof. In certain embodiments, the glycan residualcompound has a molecular weight of less than 2000 g/mol, less than 1500g/mol, less than 1000 g/mol, less than 500 g/mol, less than 400 g/mol,less than 300 g/mol, less than 260 g/mol, less than 200 g/mol, less than100 g/mol, or the like (e.g., prior to tagging with any detectable labelthat may be included in a process described herein).

In some embodiments, any process described herein further comprisespurifying a biological sample prior to transforming a glycan thereof. Insome embodiments, the process of purifying a biological sample comprisesremoving monosaccharides therefrom, removing sulfates therefrom,removing phosphates therefrom, removing acetate therefrom, or acombination thereof.

In certain embodiments, transforming a glycan of a biological samplewith a normally functioning glycan degradation enzyme comprisestransforming a glycan of a biological sample with a plurality ofnormally functioning glycan degradation enzymes. In some embodiments,the glycan is treated with a plurality of normally functioning glycandegradation enzymes concurrently, sequentially, or a combinationthereof.

In specific embodiments, a disorder associated with an abnormal glycanaccumulation is any disorder described in Tables 1-4 (e.g., MPS I) andthe normally functioning glycan degradation enzyme is any enzymedescribed in Tables 1-4 (e.g., L-iduronidase).

In some embodiments, determining whether the amount of liberated glycanresidue is abnormal comprises labeling the glycan residue with adetectable label and measuring the amount of labeled glycan residue withan analytical instrument. In certain embodiments, the detectable labelis a mass label, a radioisotope label, a fluorescent label, achromophore label, or affinity label. In some embodiments, the amount ofliberated glycan is measured using UV-V is spectroscopy, IRspectroscopy, mass spectrometry, or a combination thereof

Provided in some embodiments herein is a method of monitoring thetreatment of a disorder associated with the abnormal degradation,biosynthesis and/or accumulation of glycans, the methods comprising:

-   -   a. following administration of an agent for treating a disorder        associated with the abnormal degradation, biosynthesis and/or        accumulation of glycans to an individual in need thereof, using        an analytical instrument to measure the amount of a population        of a non-reducing end glycan residual compounds present in a        transformed biological sample that has been prepared by:        -   treating a population of glycans, in or isolated from a            biological sample taken from the individual, with at least            one normally functioning glycan degradation enzyme to            liberate non-reducing end glycan residual compound;    -   b. determining whether or not the amount of the amount of        liberated non-reducing end glycan residue has decreased or        increased at a slower rate compared to the amount or rate of        increase prior to administration of the agent for treating a        disorder associated with the abnormal degradation, biosynthesis        and/or accumulation of glycans.

In some embodiments, the disorder associated with the abnormaldegradation, biosynthesis and/or accumulation of glycans is a lysosomalstorage disease, a cancerous disease, or an infectious disease. Incertain embodiments, the normally functioning glycan degradation enzymeis a glycosidase, sulfatase, phosphorylase, deacetylase, or acombination thereof. In some embodiments, the normally functioningglycan degradation enzyme is a glycosidase selected from anexo-glycosidase and an endo-glycosidase. In certain embodiments, theglycan residual compound is a monosaccharide, sulfate, phosphate,acetate, or a combination thereof. In some embodiments, transforming aglycan of a biological sample with a normally functioning glycandegradation enzyme comprises transforming a glycan of a biologicalsample with a plurality of normally functioning glycan degradationenzymes. In certain embodiments, the glycan is treated with a pluralityof normally functioning glycan degradation enzymes concurrently,sequentially, or a combination thereof. In some embodiments, prior tomeasuring the amount of a population of non-reducing end glycan residualcompounds, the non-reducing end glycan residual compounds are labeledwith a detectable label. In certain embodiments, the detectable label isa mass label, a radioisotope label, a fluorescent label, a chromophorelabel, or affinity label. In some embodiments, the amount of liberatedglycan is measured using UV-Vis spectroscopy, IR spectroscopy, massspectrometry, or a combination thereof.

BRIEF DESCRIPTION OF THE DRAWINGS

The novel features of the invention are set forth with particularity inthe appended claims. A better understanding of the features andadvantages of the present invention will be obtained by reference to thefollowing detailed description that sets forth illustrative embodiments,in which the principles of the invention are utilized, and theaccompanying drawings of which:

FIG. 1 illustrates compounds present in a normal biological sample notsubject to an enzymatic glycan residual liberation process describedherein.

FIG. 2 illustrates compounds present in a normal biological subject toan enzymatic glycan residual liberation process described herein.

FIG. 3 illustrates compounds present in a biological sample of anindividual suffering from a disorder associated with abnormal glycanaccumulation not subject to an enzymatic glycan residual liberationprocess described herein.

FIG. 4 illustrates compounds present in a biological sample of anindividual suffering from a disorder associated with abnormal glycanaccumulation subject to an enzymatic glycan residual liberation processdescribed herein.

DETAILED DESCRIPTION OF THE INVENTION

While preferred embodiments of the present invention have been shown anddescribed herein, it will be obvious to those skilled in the art thatsuch embodiments are provided by way of example only. Numerousvariations, changes, and substitutions will now occur to those skilledin the art without departing from the invention. It should be understoodthat various alternatives to the embodiments of the invention describedherein may be employed in practicing the invention. It is intended thatthe following claims define the scope of the invention and that methodsand structures within the scope of these claims and their equivalents becovered thereby.

Provided herein is a method of detecting abnormal glycan accumulation,e.g., in human disease. In some instances, the process described hereinincludes a strategy to quantify the changes by measuring the abundanceof all glycans with a disease related glycan residual compound on thenon-reducing end of glycans from a biological sample (e.g.,monosaccharides and/or their modifications such as sulfation,acetylation, phosphorylation, or the like).

Provided in certain embodiments herein are methods of detecting glycanaccumulation in a biological sample, the method comprising:

-   -   a. transforming a glycan of a biological sample with a normally        functioning glycan degradation enzyme to liberate a glycan        residual compound from the non-reducing end of the glycan;    -   b. measuring the amount of the glycan residual compound        liberated by the functioning glycan degradation enzyme with an        analytical device.

In certain embodiments, the method is associated with diagnosing anindividual with abnormal glycan accumulation, or a disorder associatedtherewith.

Therefore, in specific embodiments, provided herein is a method ofdiagnosing an individual as having an abnormal glycan accumulation or adisorder associated with an abnormal glycan accumulation, the methodcomprising:

-   -   a. transforming a glycan of a biological sample with a normally        functioning glycan degradation enzyme to liberate a glycan        residual compound from the non-reducing end of the glycan;    -   b. measuring the amount of the glycan residual compound        liberated by the functioning glycan degradation enzyme with an        analytical device; and    -   c. determining whether the amount of liberated glycan residue is        abnormal.

In certain instances, methods of detecting abnormal glycan accumulationworks based on the observation that altered glycans generated in adisease state are caused by an alteration in the activity of abiosynthetic enzyme (e.g., via increased expression, increased activity,increased substrate, or the like) that leads to the production ofthousands of unique structures.

For example, in certain instances, the induction of an alpha 2,3sialyltransferase leads to the novel expression of thousands ofdifferent glycans (potentially from multiple glycan classes) thatpresent a non-reducing terminal alpha 2,3 linked sialic acid. Byquantifying a limited set of these novel structures using currentmethods, only a fraction of the disease related structures are measured.Instead, as provided in certain embodiments herein, if a samplecontaining glycans (crude or purified for a specific glycan class) istreated with an alpha 2,3 sialidase to liberate the non-reducing endsialic acid, the free sialic acid (non-reducing end glycan residual) canbe measured. This signal would represent a larger portion of thethousands of altered glycan structures that are made in the diseasestate due to the altered expression of the alpha 2,3 sialyltransferase.Furthermore, in certain embodiments, depending on the signal (i.e.,measurement) of the sialic acid liberated, a determination is made as towhether or not the accumulation of sialic acid is abnormal and/orwhether or not such levels of accumulated sialic acid is associated witha disorder.

Another example of the process includes a method involving a biologicalsample containing glycans (purified or not) that is treated with anexo-glycosidase (for example a β-galactosidase). In some of suchembodiments, enzymatic treatment cleaves non-reducing endmonosaccharides within the chosen enzymes specificity (e.g., β-linkedgalactose residues) and liberates them as free monosaccharide (e.g.,galactose). In various embodiments, the free monosaccharide is isolatedand quantified by any analytical method (HPLC, MS, GC, etc), and anydisease that presents changes in the levels of non-reducing end β-linkedgalactose residues is detected or diagnosed.

Similar methods are also optionally utilized in methods of monitoringand/or determining the therapeutic of a treatment or treatment regimen,particularly in the treatment of a disorder associated with abnormalglycan accumulation. For example, provided in certain embodiments hereinis a method of monitoring the treatment of disorders associated with theabnormal degradation, biosynthesis and/or accumulation of glycans, themethods comprising:

-   -   a. following administration of an agent for treating a disorder        associated with the abnormal degradation, biosynthesis and/or        accumulation of glycans to an individual in need thereof, using        an analytical instrument to measure the amount of a population        of a non-reducing end glycan residue present in a transformed        biological sample that has been prepared by:        -   treating a population of glycans, in or isolated from a            biological sample taken from the individual, with at least            one normally functioning glycan degradation enzyme to            liberate non-reducing end glycan residue;    -   b. determining whether or not the amount of the amount of        liberated non-reducing end glycan residue has decreased or        increased at a slower rate compared to the amount or rate of        increase prior to administration of the agent for treating a        disorder associated with the abnormal degradation, biosynthesis        and/or accumulation of glycans.

In some embodiments, any process described herein comprises:

-   -   a. comparing an amount of a population of one or more glycan        residual compound present in a transformed biological sample to        an amount of a population of one or more glycan residual        compound present in a control biological sample that has been        treated in a manner substantially similar to the transformed        biological sample.

In certain embodiments, a control biological sample utilized in anyprocess described herein was provided from an individual that does notsuffer from a disorder being diagnosed. In other embodiments, a controlbiological sample is taken from an individual suffering from a disorderbeing diagnosed. In certain embodiments, the result obtained from thecontrol biological sample is stored in a database. In such cases a testsample is optionally compared to a plurality of control data in adatabase. Moreover in certain embodiments, any diagnostic processdescribed herein is optionally utilized alone or in combination withother diagnostic techniques. Other diagnostic techniques include, by wayof non-limiting example, symptom analysis, biopsies, detection ofaccumulation of other compounds in biological samples, or the like. Insome embodiments, control biological samples are optionally taken fromthe same individual at substantially the same time, simply from adifferent location (e.g., one inflamed/arthritic synovial joint fluid vsthe contralateral non-arthritic synovial joint). In other embodiments,control biological samples are optionally taken from the same individualat different points in time (e.g., before therapy and after therapy ifthe method being utilized is a method of monitoring a treatmenttherapy).

Glycan Accumulation:

In various instances, glycan accumulation occurs in a biological sampleas a result natural glycan biosynthetic and/or degradation processes. Insome instances, abnormal glycan accumulation occurs in a biologicalsample as a result of a disorder or disease within an individual fromwhich the biological sample is obtained.

In certain embodiments, abnormal glycan accumulation that is observableby methods described herein is associated with the accumulation ofglycans in a manner that does not normally occur in individuals who arenot in a disease state.

In some embodiments, such accumulation includes the accumulation ofabnormal glycans. In certain instances, these abnormal glycans includeglycans that are not normally produced in an individual, or a particularbiological sample thereof, in the absence of a particular disease state.Therefore, in some embodiments, abnormal glycan accumulation includesthe accumulation of glycans, the glycans being abnormal themselves,especially in any significant quantity. In other words, such glycans areabnormal glycans in individuals or particular biological samples thereofwhen such individuals are in a non-diseased, normal, or wild type state.

In some embodiments, such accumulation includes the abnormalaccumulation of glycans. In some instances, these glycans are glycansthat normally occur in individuals in a non-diseased state, but at loweror higher levels or are abnormal only due to the location wherein theyare produced. Therefore, in some embodiments, abnormal glycanaccumulation includes the accumulation of abnormal amounts of glycans orthe location thereof, the glycans being normally occurring or abnormalglycans. In other words, the amount of glycan accumulation is abnormalin individuals, or particular biological samples thereof, when suchindividuals are in a non-diseased, normal, or wild type state.

Biological Sample:

Biological samples suitable for analysis according to the methods andprocesses described herein include, by way of non-limiting example,blood, serum, urine, hair, saliva, skin, tissue, plasma, cerebrospinalfluid (CSF), amniotic fluid, nipple aspirate, sputum, tears, lungaspirate, semen, feces, synovial fluid, nails, or the like. In specificembodiments, the biological samples suitable for analysis according tothe methods and processes described herein include, by way ofnon-limiting example, urine, serum, plasma, or CSF. In certainembodiments, processes for detecting glycan in a sample compriseproviding, from the individual, a test biological sample that comprisesglycan. In some embodiments, providing a test biological sample from anindividual includes obtaining the sample from the individual orobtaining the sample from another source (e.g., from a technician orinstitution that obtained the sample from the individual). In someembodiments, the biological sample is obtained from any suitable source,e.g., any tissue or cell (e.g., urine, serum, plasma, or CSF) of anindividual. In certain embodiments, the tissue and/or cell from whichthe glycans are recovered is obtained from liver tissue or cells, braintissue or cells, kidney tissue or cells, or the like.

In certain embodiments, a biological sample according to any processdescribed herein is taken from any individual. In some embodiments, theindividual is an individual suspected of suffering from a disorderassociated with abnormal glycan accumulation, biosynthesis, and/ordegradation. In certain embodiments, the individual is a newborn orfetus.

In some embodiments, provided herein is a composition comprisingisolated glycans, wherein the glycans were isolated from a biologicalsample, and one or more glycan degradation enzyme. In certainembodiments, the composition further comprises one or more biomarkergenerated according to any method described herein (e.g., wherein thebiomarker is a non-reducing end glycan residual compound). In certainembodiments, provided herein is a biomarker described herein (e.g., alabeled or non-labeled non-reducing end glycan residual compound) and ananalytical instrument or chromatographic resin.

Degradation Enzymes:

In certain embodiments, any suitable enzyme is optionally utilized inorder to remove a glycan residual compound from the non-reducing end ofa glycan. In certain disorders, e.g., as described herein, various typesof abnormal glycan accumulation occurs. In certain instances, this typeof glycan accumulation is detected and/or measured utilizing anysuitable enzyme, e.g., as described herein. For example, Tables 1-4illustrate various enzymes that are utilized in various embodiments ofthe processes described herein. Any enzyme with the desired specificityis optionally utilized in any process herein (i.e., to liberate thenon-reducing end structures). Enzymes suitable for use in the processesdescribed herein include, by way of non-limiting example, eukaryotic,prokaryotic, native, or recombinant enzymes.

In certain embodiments, a disorder associated with abnormal glycanaccumulation includes a disorder associated therewith is caused by anabnormally functioning glycan degradation enzyme. In variousembodiments, the abnormally functioning glycan degradation enzymefunctions abnormally as a result of being present in an abnormally lowamount, functioning improperly, or a combination thereof. For example,an abnormally functioning glycan degradation enzyme functions abnormallyas a result of being present in an amount of less than 50%, less than40%, less than 30%, less than 20%, less than 10%, or less than 5% thanis present in an individual with normal amounts of the glycandegradation enzyme (e.g., an individual in a non-diseased, normal, orwild type state). In further or alternative embodiments, abnormallyfunctioning glycan degradation enzymes are present in a normal amount,but do not function properly in degrading glycans. For example, suchenzymes may be have amino acid substitutions in the sequences thereofthat reduce or eliminate the glycan degradative properties of theenzyme.

In some embodiments, wherein abnormal glycan accumulation results, atleast partially from, an abnormally functioning glycan degradationenzyme, a normally functioning glycan degradation is optionallyutilized, particularly wherein the abnormally functioning glycandegradation enzyme and the normally functioning glycan degradationenzyme are of the same type.

Normally functioning glycan degradation enzymes that are used in variousembodiments described herein include, by way of non-limiting example,glycosidases, sulfatases, phosphorylases, deacetylases, sialidases, orcombinations thereof. In more specific embodiments, a normallyfunctioning glycan degradation enzyme is a glycosidase, e.g., anexo-glycosidase or an endo-glycosidase. In more specific embodiments,the glycosidase is an exo-glycosidase, e.g., galactosidase, and aglucuronidase. In some embodiments, such enzymes serve to remove variousglycan residual compounds, such as, monosaccharides, sulfate, phosphate,acetate, sialic acid, or combinations thereof, which are detected and/ormeasured in methods described herein.

In certain embodiments, one or normally functioning glycan degradationenzyme is optionally utilized to liberate a targeted glycan residualcompound. Multiple enzyme treatments of glycans within a biologicalsample are useful in various embodiments, e.g., wherein a particularenzyme is unable to liberate a targeted residual glycan compound withoutfirst modifying the non-reducing end of the glycan. For example, a firstenzyme is optionally utilized to remove a sulfate so that a secondenzyme can be utilized to remove a monosaccharide. In variousembodiments, the glycans are treated with a plurality of normallyfunctioning glycan degradation enzymes concurrently, sequentially, or acombination thereof

Various enzymes that are used in various embodiments of the methodsdescribed herein include, by way of non-limiting example, a glycosidase.Non-limiting examples of glycosidase that are optionally utilized in themethods described herein include, by way of non-limiting example,enzymes categorized as 3.2.1.X by BRENDA (the comprehensive EnzymeInformation System) including 3.2.1.1 alpha-amylase, 3.2.1.B1extracellular agarase, 3.2.1.2 beta-amylase, 3.2.1.3 glucan1,4-alpha-glucosidase, 3.2.1.4 cellulase, 3.2.1.5 licheninase, 3.2.1.6endo-1,3(4)-beta-glucanase, 3.2.1.7 inulinase, 3.2.1.8endo-1,4-beta-xylanase, 3.2.1.9 amylopectin-1,6-glucosidase, 3.2.1.10oligo-1,6-glucosidase, 3.2.1.11 dextranase, 3.2.1.12cycloheptaglucanase, 3.2.1.13 cyclohexaglucanase, 3.2.1.14 chitinase,3.2.1.15 polygalacturonase, 3.2.1.16 alginase, 3.2.1.17 lysozyme,3.2.1.18 exo-alpha-sialidase, 3.2.1.19 heparinase, 3.2.1.20alpha-glucosidase, 3.2.1.21 beta-glucosidase, 3.2.1.22alpha-galactosidase, 3.2.1.23 beta-galactosidase, 3.2.1.24alpha-mannosidase, 3.2.1.25 beta-mannosidase, 3.2.1.26beta-fructofuranosidase, 3.2.1.27 alpha-1,3-glucosidase, 3.2.1.28alpha,alpha-trehalase, 3.2.1.29 chitobiase, 3.2.1.30beta-D-acetylglucosaminidase, 3.2.1.31 beta-glucuronidase, 3.2.1.32xylan endo-1,3-beta-xylosidase, 3.2.1.33 amylo-alpha-1,6-glucosidase,3.2.1.34 chondroitinase, 3.2.1.35 hyaluronoglucosaminidase, 3.2.1.36hyaluronoglucuronidase, 3.2.1.37 xylan 1,4-beta-xylosidase, 3.2.1.38beta-D-fucosidase, 3.2.1.39 glucan endo-1,3-beta-D-glucosidase, 3.2.1.40alpha-L-rhamnosidase, 3.2.1.41 pullulanase, 3.2.1.42 GDP-glucosidase,3.2.1.43 beta-L-rhamnosidase, 3.2.1.44 fucoidanase, 3.2.1.45glucosylceramidase, 3.2.1.46 galactosylceramidase, 3.2.1.47galactosylgalactosylglucosylceramidase, 3.2.1.48 sucrosealpha-glucosidase, 3.2.1.49 alpha-N-acetylgalactosaminidase, 3.2.1.50alpha-N-acetylglucosaminidase, 3.2.1.51 alpha-L-fucosidase, 3.2.1.52beta-N-acetylhexosaminidase, 3.2.1.53 beta-N-acetylgalactosaminidase,3.2.1.54 cyclomaltodextrinase, 3.2.1.55 alpha-N-arabinofuranosidase,3.2.1.56 glucuronosyl-disulfoglucosamine glucuronidase, 3.2.1.57isopullulanase, 3.2.1.58 glucan 1,3-beta-glucosidase, 3.2.1.59 glucanendo-1,3-alpha-glucosidase, 3.2.1.60 glucan1,4-alpha-maltotetraohydrolase, 3.2.1.61 mycodextranase, 3.2.1.62glycosylceramidase, 3.2.1.63 1,2-alpha-L-fucosidase, 3.2.1.642,6-beta-fructan 6-levanbiohydrolase, 3.2.1.65 levanase, 3.2.1.66quercitrinase, 3.2.1.67 galacturan 1,4-alpha-galacturonidase, 3.2.1.68isoamylase, 3.2.1.69 amylopectin 6-glucanohydrolase, 3.2.1.70 glucan1,6-alpha-glucosidase, 3.2.1.71 glucan endo-1,2-beta-glucosidase,3.2.1.72 xylan 1,3-beta-xylosidase, 3.2.1.73 licheninase, 3.2.1.74glucan 1,4-beta-glucosidase, 3.2.1.75 glucan endo-1,6-beta-glucosidase,3.2.1.76 L-iduronidase, 3.2.1.77 mannan 1,2-(1,3)-alpha-mannosidase,3.2.1.78 mannan endo-1,4-beta-mannosidase, 3.2.1.79alpha-L-arabinofuranoside hydrolase, 3.2.1.80 fructan beta-fructosidase,3.2.1.81 beta-agarase, 3.2.1.82 exo-poly-alpha-galacturonosidase,3.2.1.83 kappa-carrageenase, 3.2.1.84 glucan 1,3-alpha-glucosidase,3.2.1.85 6-phospho-beta-galactosidase, 3.2.1.866-phospho-beta-glucosidase, 3.2.1.87 capsular-polysaccharideendo-1,3-alpha-galactosidase, 3.2.1.88 beta-L-arabinosidase, 3.2.1.89arabinogalactan endo-1,4-beta-galactosidase, 3.2.1.90 arabinogalactanendo-1,3-beta-galactosidase, 3.2.1.91 cellulose 1,4-beta-cellobiosidase,3.2.1.92 peptidoglycan beta-N-acetylmuramidase, 3.2.1.93alpha,alpha-phosphotrehalase, 3.2.1.94 glucan 1,6-alpha-isomaltosidase,3.2.1.95 dextran 1,6-alpha-isomaltotriosidase, 3.2.1.96mannosyl-glycoprotein endo-beta-N-acetylglucosaminidase, 3.2.1.97glycopeptide alpha-N-acetylgalactosaminidase, 3.2.1.98 glucan1,4-alpha-maltohexaosidase, 3.2.1.99 arabinanendo-1,5-alpha-L-arabinosidase, 3.2.1.100 mannan 1,4-mannobiosidase,3.2.1.101 mannan endo-1,6-alpha-mannosidase, 3.2.1.102blood-group-substance endo-1,4-beta-galactosidase, 3.2.1.103keratan-sulfate endo-1,4-beta-galactosidase, 3.2.1.104steryl-beta-glucosidase, 3.2.1.105 3alpha(S)-strictosidinebeta-glucosidase, 3.2.1.106 mannosyl-oligosaccharide glucosidase,3.2.1.107 protein-glucosylgalactosylhydroxylysine glucosidase, 3.2.1.108lactase, 3.2.1.109 endogalactosaminidase, 3.2.1.110 mucinaminylserinemucinaminidase, 3.2.1.111 1,3-alpha-L-fucosidase, 3.2.1.1122-deoxyglucosidase, 3.2.1.113 mannosyl-oligosaccharide1,2-alpha-mannosidase, 3.2.1.114 mannosyl-oligosaccharide1,3-1,6-alpha-mannosidase, 3.2.1.115 branched-dextranexo-1,2-alpha-glucosidase, 3.2.1.116 glucan1,4-alpha-maltotriohydrolase, 3.2.1.117 amygdalin beta-glucosidase,3.2.1.118 prunasin beta-glucosidase, 3.2.1.119 vicianinbeta-glucosidase, 3.2.1.120 oligoxyloglucan beta-glycosidase, 3.2.1.121polymannuronate hydrolase, 3.2.1.122 maltose-6′-phosphate glucosidase,3.2.1.123 endoglycosylceramidase, 3.2.1.124 3-deoxy-2-octulosonidase,3.2.1.125 raucaffricine beta-glucosidase, 3.2.1.126 coniferinbeta-glucosidase, 3.2.1.127 1,6-alpha-L-fucosidase, 3.2.1.128glycyrrhizinate beta-glucuronidase, 3.2.1.129 endo-alpha-sialidase,3.2.1.130 glycoprotein endo-alpha-1,2-mannosidase, 3.2.1.131 xylanalpha-1,2-glucuronosidase, 3.2.1.132 chitosanase, 3.2.1.133 glucan1,4-alpha-maltohydrolase, 3.2.1.134 difructose-anhydride synthase,3.2.1.135 neopullulanase, 3.2.1.136 glucuronoarabinoxylanendo-1,4-beta-xylanase, 3.2.1.137 mannan exo-1,2-1,6-alpha-mannosidase,3.2.1.138 anhydrosialidase, 3.2.1.139 alpha-glucuronidase, 3.2.1.140lacto-N-biosidase, 3.2.1.141 4-alpha-D-{(1->4)-alpha-D-glucano}trehalosetrehalohydrolase, 3.2.1.142 limit dextrinase, 3.2.1.143 poly(ADP-ribose)glycohydrolase, 3.2.1.144 3-deoxyoctulosonase, 3.2.1.145 galactan1,3-beta-galactosidase, 3.2.1.146 beta-galactofuranosidase, 3.2.1.147thioglucosidase, 3.2.1.148 ribosylhomocysteinase, 3.2.1.149beta-primeverosidase, 3.2.1.150 oligoxyloglucan reducing-end-specificcellobiohydrolase, 3.2.1.151 xyloglucan-specificendo-beta-1,4-glucanase, 3.2.1.152 mannosylglycoproteinendo-beta-mannosidase, 3.2.1.153 fructan beta-(2,1)-fructosidase,3.2.1.154 fructan beta-(2,6)-fructosidase, 3.2.1.155 xyloglucan-specificexo-beta-1,4-glucanase, 3.2.1.156 oligosaccharide reducing-end xylanase,3.2.1.157 iota-carrageenase 3.2.1.158 alpha-agarase, 3.2.1.159alpha-neoagaro-oligosaccharide hydrolase, 3.2.1.160 xyloglucan-specificexo-beta-1,4-glucanase, 3.2.1.161 beta-apiosyl-beta-glucosidase,3.2.1.162 lambda-carrageenase, 3.2.1.163 1,6-alpha-D-mannosidase,3.2.1.164 galactan endo-1,6-beta-galactosidase, 3.2.1.165exo-1,4-beta-D-glucosaminidase, or a combination thereof.

Other enzymes that are used in various embodiments of the methodsdescribed herein include, by way of non-limiting example, a sulfataseincluding, e.g., enzymes categorized as 3.1.6.X by BRENDA (thecomprehensive Enzyme Information System) including 3.1.6.1arylsulfatase, 3.1.6.2 steryl-sulfatase, 3.1.6.3 glycosulfatase, 3.1.6.4N-acetylgalactosamine-6-sulfatase, 3.1.6.5 sinigrin sulfohydrolase;myrosulfatase, 3.1.6.6 choline-sulfatase, 3.1.6.7cellulose-polysulfatase, 3.1.6.8 cerebroside-sulfatase, 3.1.6.9chondro-4-sulfatase, 3.1.6.10 chondro-6-sulfatase, 3.1.6.11disulfoglucosamine-6-sulfatase, 3.1.6.12N-acetylgalactosamine-4-sulfatase, 3.1.6.13 iduronate-2-sulfatase,3.1.6.14 N-acetylglucosamine-6-sulfatase, 3.1.6.15N-sulfoglucosamine-3-sulfatase, 3.1.6.16 monomethyl-sulfatase, 3.1.6.17D-lactate-2-sulfatase, 3.1.6.18 glucuronate-2-sulfatase, 3.10.1.1N-sulfoglucosamine sulfohydrolase, or combinations thereof.

Certain enzymes that are used in various embodiments of the methodsdescribed herein include, by way of non-limiting example, a deacetylase,e.g., an exo-deacetylase, including, by way of non-limiting example, thealpha-glucosaminide N-acetyltransferase (2.3.1.78) or similar enzymes.

Certain enzymes that are used in various embodiments of the methodsdescribed herein include, by way of non-limiting example, a carbohydratephosphatase including, e.g., 3.1.3.1 alkaline phosphatase, 3.1.3.2 acidphosphatase, 3.1.3.B2 diacylglycerol pyrophosphate phosphatase, 3.1.3.3phosphoserine phosphatase, 3.1.3.4 phosphatidate phosphatase, 3.1.3.55′-nucleotidase, 3.1.3.6 3′-nucleotidase, 3.1.3.7 3′(2′),5′-bisphosphatenucleotidase, 3.1.3.8 3-phytase, 3.1.3.9 glucose-6-phosphatase, 3.1.3.10glucose-1-phosphatase, 3.1.3.11 fructose-bisphosphatase, 3.1.3.12trehalose-phosphatase, 3.1.3.13 bisphosphoglycerate phosphatase,3.1.3.14 methylphosphothioglycerate phosphatase, 3.1.3.15histidinol-phosphatase, 3.1.3.16 phosphoprotein phosphatase, 3.1.3.17[phosphorylase]phosphatase, 3.1.3.18 phosphoglycolate phosphatase,3.1.3.19 glycerol-2-phosphatase, 3.1.3.20 phosphoglycerate phosphatase,3.1.3.21 glycerol-1-phosphatase, 3.1.3.22 mannitol-1-phosphatase,3.1.3.23 sugar-phosphatase, 3.1.3.24 sucrose-phosphate phosphatase,3.1.3.25 inositol-phosphate phosphatase, 3.1.3.26 4-phytase, 3.1.3.27phosphatidylglycerophosphatase, 3.1.3.28 ADP-phosphoglyceratephosphatase, 3.1.3.29 N-acylneuraminate-9-phosphatase, 3.1.3.303′-phosphoadenylylsulfate 3′-phosphatase, 3.1.3.31 nucleotidase,3.1.3.32 polynucleotide 3′-phosphatase, 3.1.3.33 polynucleotide5′-phosphatase, 3.1.3.34 deoxynucleotide 3′-phosphatase, 3.1.3.35thymidylate 5′-phosphatase, 3.1.3.36 phosphoinositide 5-phosphatase,3.1.3.37 sedoheptulose-bisphosphatase, 3.1.3.38 3-phosphoglyceratephosphatase, 3.1.3.39 streptomycin-6-phosphatase, 3.1.3.40guanidinodeoxy-scyllo-inositol-4-phosphatase, 3.1.3.414-nitrophenylphosphatase, 3.1.3.42 [glycogen-synthase-D] phosphatase,3.1.3.43 [pyruvate dehydrogenase (acetyl-transferring)]-phosphatase,3.1.3.44 [acetyl-CoA carboxylase]-phosphatase, 3.1.3.453-deoxy-manno-octulosonate-8-phosphatase, 3.1.3.46fructose-2,6-bisphosphate 2-phosphatase, 3.1.3.47[hydroxymethylglutaryl-CoA reductase (NADPH)]-phosphatase, 3.1.3.48protein-tyrosine-phosphatase, 3.1.3.49 [pyruvate kinase]-phosphatase,3.1.3.50 sorbitol-6-phosphatase, 3.1.3.51 dolichyl-phosphatase, 3.1.3.52[3-methyl-2-oxobutanoate dehydrogenase(2-methylpropanoyl-transferring)]-phosphatase, 3.1.3.53[myosin-light-chain] phosphatase, 3.1.3.54 fructose-2,6-bisphosphate6-phosphatase, 3.1.3.55 caldesmon-phosphatase, 3.1.3.56inositol-polyphosphate 5-phosphatase, 3.1.3.57 inositol-1,4-bisphosphate1-phosphatase, 3.1.3.58 sugar-terminal-phosphatase, 3.1.3.59alkylacetylglycerophosphatase, 3.1.3.60 phosphoenolpyruvate phosphatase,3.1.3.61 inositol-1,4,5-trisphosphate 1-phosphatase, 3.1.3.62 multipleinositol-polyphosphate phosphatase, 3.1.3.632-carboxy-D-arabinitol-1-phosphatase, 3.1.3.64phosphatidylinositol-3-phosphatase, 3.1.3.65 inositol-1,3-bisphosphate3-phosphatase, 3.1.3.66 phosphatidylinositol-3,4-bisphosphate4-phosphatase, 3.1.3.67 phosphatidylinositol-3,4,5-trisphosphate3-phosphatase, 3.1.3.68 2-deoxyglucose-6-phosphatase, 3.1.3.69glucosylglycerol 3-phosphatase, 3.1.3.70 mannosyl-3-phosphoglyceratephosphatase, 3.1.3.71 2-phosphosulfolactate phosphatase, 3.1.3.725-phytase, 3.1.3.73 alpha-ribazole phosphatase, 3.1.3.74 pyridoxalphosphatase, 3.1.3.75 phosphoethanolamine/phosphocholine phosphatase,3.1.3.76 lipid-phosphate phosphatase, 3.1.3.77 acireductone synthase,3.1.3.78 phosphatidylinositol-4,5-bisphosphate 4-phosphatase, or3.1.3.79 mannosylfructose-phosphate phosphatase, or a combinationthereof

In some embodiments, processes described herein include incubation anddigestion with a first enzyme to clear a specific non-reducing endstructure, incubation and digestion with a second enzyme. In certainembodiments, this multi-enzyme approach is useful in order to reduce thebackground. For example, in MPS II treating the sample with aniduronidase and/or glucuronidase to clear all non-sulfated non-reducingend uronic acids (this enzyme will not cleave sulfated iduronic acids)before 2-O sulfatase treatment. This approach will clear allnon-sulfated non-reducing end uronic acids so that upon desulfation withthe 2-O sulfatase the newly releasable uronic acids will be those thatwere previously sulfated (and therefore resistant to the action of theiduronidase and/or glucuronidase).

Glycan Residual Compounds:

Glycan residual compounds detected, measured, analyzed, and/or otherwisecharacterized according to any process described herein include anysuitable glycan residue that is liberated from the non-reducing end of aglycan (e.g., a glycan obtained from a biological sample of anindividual). In specific instances, glycan residual compounds including,e.g., oligosaccharides, monosaccharides, sulfate, phosphate, sialicacid, acetate, or the like.

Specific glycan residual compounds useful in any process herein aredescribed in Tables 1-4.

In some embodiments, the generated biomarker is a glycan residualcompound. In some embodiments, the glycan residual compound is amonosaccharide. In certain embodiments, the glycan residual compound issulfate, phosphate, acetate, or a combination thereof. In certainembodiments, the glycan residual compound has a molecular weight of lessthan 2000 g/mol, less than 1500 g/mol, less than 1000 g/mol, less than500 g/mol, less than 400 g/mol, less than 300 g/mol, less than 260g/mol, less than 200 g/mol, less than 100 g/mol, or the like (e.g.,prior to tagging with any detectable label that may be included in aprocess described herein).

Disorders:

In certain embodiments, a disorder associated with abnormal glycanaccumulation includes a disorder associated therewith is caused by anabnormally functioning glycan degradation enzyme. In variousembodiments, the abnormally functioning glycan degradation enzymefunctions abnormally as a result of being present in an abnormally lowamount, functioning improperly, or a combination thereof. For example,an abnormally functioning glycan degradation enzyme functions abnormallyas a result of being present in an amount of less than 50%, less than40%, less than 30%, less than 20%, less than 10%, or less than 5% thanis present in an individual with normal amounts of the glycandegradation enzyme (e.g., an individual in a non-diseased, normal, orwild type state). In further or alternative embodiments, abnormallyfunctioning glycan degradation enzymes are present in a normal amount,but do not function properly in degrading glycans. For example, suchenzymes may be have amino acid substitutions in the sequences thereofthat reduce or eliminate the glycan degradative properties of theenzyme.

MPS I is a human genetic disease caused by a deficiency in the lysosomalenzyme L-iduronidase. This enzyme is required in the lysosome to degradeglycans that contain iduronic acid. Due to this enzymatic deficiency,glycans with an iduronic acid on the non-reducing end accumulate to highlevels (including heparan sulfate and dermatan sulfate). In certainembodiments, using the method described herein, MPS I is diagnosed in anindividual from a biological sample taken therefrom. For example, insome embodiments, a biological sample is optionally placed into adefined MW cut off spin column (retains large molecules when spun),optionally washed (e.g., with water or buffer) to remove freemonosaccharides, then treated with an iduronidase (e.g., to liberate aglycan residual compound iduronic acid). In certain embodiments, afterincubation, the liberated iduronic acid is isolated, e.g., by washingthe free monosaccharide through the defined MW cut off membrane (orother methods). In some of such embodiments, the monosaccharide would bein the flow through. The isolated monosaccharide solution is optionallydried or otherwise treated to concentrate the sample and subsequentlyanalyzed for iduronic acid content by any suitable analytical technique(e.g., HPLC, MS, GC, or the like with or without chemical or enzymaticderivatization before detection). This method can be used to detect MPSI disease, measure disease severity, or to measure response to therapy.

MPS II is a human genetic disease caused by a deficiency in thelysosomal enzyme 2-sulfatase. This enzyme is required in the lysosome todegrade glycans that contain 2-O sulfated uronic acids. Due to thisenzymatic deficiency, glycans with a 2-sulfated uronic acid on thenon-reducing end accumulate to high levels (including heparan sulfateand dermatan sulfate). In certain embodiments, using the methoddescribed herein, MPS II is diagnosed in an individual from a biologicalsample taken therefrom. For example, in some embodiments, a biologicalsample is optionally placed in to a defined MW cut off spin column(retains large molecules when spun), optionally washed (e.g., with 1 ormore volumes of water or buffer to remove free sulfate), and treatedwith a 2-sulfatase (e.g., to liberate a glycan residual compoundsulfate). In some embodiments, after incubation, the liberated sulfateis optionally isolated by washing the free monosaccharide (e.g., througha defined MW cut off membrane or by any other suitable method). In someof such embodiments, the free sulfate is in the flow through. In certainembodiments, the resulting isolated solution is optionally dried orotherwise treated to concentrate the sample and subsequently analyzedfor sulfate content by any suitable analytical technique (e.g., HPLC,MS, GC, pH detection, or the like with or without chemical or enzymaticderivatization before detection). This method can be used to detect MPSII disease, measure disease severity, or to measure response to therapy.In other exemplary embodiments, following treatment with a 2-sulfatase,the resulting 2-O desulfated non-reducing end uronic acid residues isoptionally liberated with an iduronidase or glucuronidase. In some ofsuch embodiments, the resulting liberated monosaccharide is optionallyisolated, e.g., by washing free monosaccharide (e.g., through thedefined MW cut off membrane or any other suitable method). In some ofsuch embodiments, free iduronic or glucuronic acid is in the flowthrough. In certain embodiments, the resulting isolated solution isoptionally dried or otherwise treated to concentrate the sample andsubsequently analyzed for monosaccharide content by any suitableanalytical technique (e.g., HPLC, MS, GC, or the like with or withoutchemical or enzymatic derivatization before detection). This method canbe used to detect MPS II disease, measure disease severity, or tomeasure response to therapy.

MPS IIIA is a human genetic disease caused by a deficiency in thelysosomal enzyme N-sulfatase. This enzyme is required in the lysosome todegrade glycans that contain N-sulfated glucosamine residues. Due tothis enzymatic deficiency, glycans with N-sulfated glucosamine residueson the non-reducing end accumulate to high levels (including heparansulfate). In certain embodiments, using the method described herein, MPSIIIA is diagnosed in an individual from a biological sample takentherefrom. For example, in some embodiments, a biological sample isoptionally placed in to a defined MW cut off spin column (retains largemolecules when spun), optionally washed (e.g., with 1 or more volumes ofwater or buffer) to remove free sulfate, and treated with anN-sulfatase. In certain embodiments, after incubation, the liberatedsulfate is optionally isolated, e.g., by washing the free monosaccharide(such as through a defined MW cut off membrane or any other suitablemethod). In some of such embodiments, free sulfate for detection and/orquantitation in the flow through. In certain embodiments, the resultingisolated solution is optionally dried or otherwise treated toconcentrate the sample and subsequently analyzed for sulfate content byany suitable analytical technique (e.g., HPLC, MS, GC, pH detection, orthe like with or without chemical or enzymatic derivatization beforedetection). This method can be used to detect MPS IIIA disease, measuredisease severity, or to measure response to therapy. In further oralternative embodiments, following treatment with an N-sulfatase, theresulting N-desulfated non-reducing end glucosamine residues isoptionally liberated with a hexosaminidase. In some of such embodiments,liberated monosaccharide is optionally isolated (e.g., by washing thefree monosaccharide, such as through the defined MW cut off membrane orany other suitable method). In some of such embodiments, freeglucosamine for detection and/or quantitation is present in the flowthrough. In certain embodiments, the resulting isolated solution isoptionally dried or otherwise treated to concentrate the sample andsubsequently analyzed for monosaccharide content by any suitableanalytical technique (e.g., HPLC, MS, GC, or the like with or withoutchemical or enzymatic derivatization before detection). This method canbe used to detect MPS IIIA disease, measure disease severity, or tomeasure response to therapy.

As discussed above, in certain embodiments, using the method describedherein, MPS IIIA is diagnosed in an individual from a biological sampletaken therefrom. For example, in some embodiments, a biological sampleis optionally placed in to a defined MW cut off spin column (retainslarge molecules when spun), optionally washed (e.g., with 1 or morevolumes of water or buffer) to remove free monosaccharide, and treatedwith an N-sulfo glucosaminidase such as a heparin lyase. In someembodiments, liberated sulfated monosaccharide is optionally isolated,e.g., by washing the free monosaccharide (such as through the defined MWcut off membrane or by any other suitable method). In some of suchembodiments, free N-sulfated glucosamine for detection and/orquantitation is present in the flow through. In certain embodiments, theresulting isolated solution is optionally dried or otherwise treated toconcentrate the sample and subsequently analyzed for monosaccharidecontent by any suitable analytical technique (e.g., HPLC, MS, GC, or thelike with or without chemical or enzymatic derivatization beforedetection). This method can be used to detect MPS IIIA disease, measuredisease severity, or to measure response to therapy.

As discussed above, in certain embodiments, using the method describedherein, MPS IIIA is diagnosed in an individual from a biological sampletaken therefrom. For example, in some embodiments, a biological sampleis optionally placed in to a defined MW cut off spin column (retainslarge molecules when spun), optionally washed (e.g., with 1 or morevolumes of water or buffer) to remove free monosaccharide, and treatedwith an N-sulfatase. In certain embodiments, the resulting glycan issubsequently treated such that the N-desulfated non-reducing endglucosamine residues is acetylated (e.g., with an N-acetyl transferase)and subsequently liberated with a hexosaminidase. In some of suchembodiments, the resulting liberated monosaccharide is optionallyisolated, e.g., by washing the free monosaccharide (e.g., through adefined MW cut off membrane or any other suitable methods). In some ofsuch embodiments, free N-acetyl glucosamine for detection and/orquantitation is present in the flow through. In certain embodiments, theresulting isolated composition is optionally dried or otherwise treatedto concentrate the sample and subsequently analyzed for monosaccharidecontent by any suitable analytical technique (e.g., HPLC, MS, GC, or thelike with or without chemical or enzymatic derivatization beforedetection). This method can be used to detect MPS IIIA disease, measuredisease severity, or to measure response to therapy.

MPS IIIB is a human genetic disease caused by a deficiency in the enzymeN-acetyl glucosaminidase. This enzyme is required in the lysosome todegrade glycans that contain N-acetyl glucosamine residues. Due to thisenzymatic deficiency, glycans with a N-acetyl glucosamine residue on thenon-reducing end accumulate to high levels (including heparan sulfate).In certain embodiments, using the method described herein, MPS IIIB isdiagnosed in an individual from a biological sample taken therefrom. Forexample, in some embodiments, a biological sample is optionally placedin to a defined MW cut off spin column (retains large molecules whenspun), optionally washed (e.g., with 1 or more volumes of water orbuffer to remove free N-acetyl glucosamine), and treated with a-acetylglucosaminidase or a heparin lyase (e.g., to liberate a glycan residualcompound N-acetyl glucosamine). In some embodiments, after incubation,the liberated N-acetyl glucosamine is optionally isolated by washing thefree monosaccharide (e.g., through a defined MW cut off membrane or byany other suitable method). In some of such embodiments, the freemonosaccharide is in the flow through. In certain embodiments, theresulting isolated solution is optionally dried or otherwise treated toconcentrate the sample and subsequently analyzed for monosaccharidecontent by any suitable analytical technique (e.g., HPLC, MS, GC, pHdetection, or the like with or without chemical or enzymaticderivatization before detection). This method can be used to detect MPSIIIB disease, measure disease severity, or to measure response totherapy.

As discussed above, in certain embodiments, using the method describedherein, MPS IIIA is diagnosed in an individual from a biological sampletaken therefrom. For example, in some embodiments, a biological sampleis optionally placed in to a defined MW cut off spin column (retainslarge molecules when spun), optionally washed (e.g., with 1 or morevolumes of water or buffer) to remove free acetate, and treated with adeacetylase. The liberated acetate is optionally isolated, e.g., bywashing the free acetate (such as through the defined MW cut offmembrane or any other suitable method). In some of such embodiments, thefree acetate for detection and/or quantitation is present the flowthrough. In some embodiments, the resulting isolated solution isoptionally dried or otherwise treated to concentrate the sample andsubsequently analyzed for acetate content by any suitable analyticaltechnique (e.g., HPLC, MS, GC, pH detection, or the like with or withoutchemical or enzymatic derivatization before detection). This method canbe used to detect MPS IIIB disease, measure disease severity, or tomeasure response to therapy.

MPS IIIC is a human genetic disease caused by a deficiency in the enzymeN-acetyltransferase. This enzyme is required in the lysosome to degradeglycans that contain glucosamine residues. Due to this enzymaticdeficiency, glycans with a glucosamine residue on the non-reducing endaccumulate to high levels (including heparan sulfate). In certainembodiments, using the method described herein, MPS IIIC is diagnosed inan individual from a biological sample taken therefrom. For example, insome embodiments, a biological sample is optionally placed in to adefined MW cut off spin column (retains large molecules when spun),optionally washed (e.g., with 1 or more volumes of water or buffer toremove free glucosamine), and treated with a hexosaminidase or heparinlyase (e.g., to liberate a glycan residual compound glucosamine). Insome embodiments, after incubation, the liberated glucosamine isoptionally isolated by washing the free glucosamine (e.g., through adefined MW cut off membrane or by any other suitable method). In some ofsuch embodiments, the free glucosamine for detection and/or quantitationis present in the flow through. In certain embodiments, the resultingisolated solution is optionally dried or otherwise treated toconcentrate the sample and subsequently analyzed for monosaccharidecontent by any suitable analytical technique (e.g., HPLC, MS, GC, pHdetection, or the like with or without chemical or enzymaticderivatization before detection). This method can be used to detect MPSIIIC disease, measure disease severity, or to measure response totherapy.

As discussed above, in certain embodiments, using the method describedherein, MPS IIIC is diagnosed in an individual from a biological sampletaken therefrom. For example, in some embodiments, a biological sampleis optionally placed in to a defined MW cut off spin column (retainslarge molecules when spun), optionally washed (e.g., with 1 or morevolumes of water or buffer to remove free glucosamine and/or N-acetylglucosamine), and treated with a glucosamine N-acetyltransferasefollowed by a hexosaminidase (e.g., to liberate a glycan residualcompound N-acetyl glucosamine). In some embodiments, after incubation,the liberated N-acetyl glucosamine is optionally isolated by washing thefree N-acetyl glucosamine (e.g., through a defined MW cut off membraneor by any other suitable method). In some of such embodiments, the freeN-acetyl glucosamine for detection and/or quantitation is present in theflow through. In certain embodiments, the resulting isolated solution isoptionally dried or otherwise treated to concentrate the sample andsubsequently analyzed for monosaccharide content by any suitableanalytical technique (e.g., HPLC, MS, GC, pH detection, or the like withor without chemical or enzymatic derivatization before detection). Thismethod can be used to detect MPS IIIC disease, measure disease severity,or to measure response to therapy.

MPS IIID is a human genetic disease caused by a deficiency in the enzymeglucosamine 6-O sulfatase. This enzyme is required in the lysosome todegrade glycans that contain 6-O-sulfated glucosamine residues. Due tothis enzymatic deficiency, glycans with a 6-O-sulfated N-acetylglucosamine residue on the non-reducing end accumulate to high levels(including heparan sulfate). In certain embodiments, using the methoddescribed herein, MPS IIIC is diagnosed in an individual from abiological sample taken therefrom. For example, in some embodiments, abiological sample is optionally placed in to a defined MW cut off spincolumn (retains large molecules when spun), optionally washed (e.g.,with 1 or more volumes of water or buffer to remove free sulfate), andtreated with a 6-O-sulfatase (e.g., to liberate a glycan residualcompound sulfate). In some embodiments, after incubation, the liberatedsulfate is optionally isolated by washing the free sulfate (e.g.,through a defined MW cut off membrane or by any other suitable method).In some of such embodiments, the free sulfate for detection and/orquantitation is present in the flow through. In certain embodiments, theresulting isolated solution is optionally dried or otherwise treated toconcentrate the sample and subsequently analyzed for sulfate content byany suitable analytical technique (e.g., HPLC, MS, GC, pH detection, orthe like with or without chemical or enzymatic derivatization beforedetection). This method can be used to detect MPS HID disease, measuredisease severity, or to measure response to therapy.

As discussed above, in certain embodiments, using the method describedherein, MPS IIID is diagnosed in an individual from a biological sampletaken therefrom. For example, in some embodiments, a biological sampleis optionally placed in to a defined MW cut off spin column (retainslarge molecules when spun), optionally washed (e.g., with 1 or morevolumes of water or buffer to remove free sulfate and/or N-acetylglucosamine), and treated with a 6-O-sulfatase and a hexosaminidase(e.g., to liberate a glycan residual compound N-acetyl glucosamine). Insome embodiments, after incubation, the liberated N-acetyl glucosamineis optionally isolated by washing the free N-acetyl glucosamine (e.g.,through a defined MW cut off membrane or by any other suitable method).In some of such embodiments, the free monosaccharide for detectionand/or quantitation is present in the flow through. In certainembodiments, the resulting isolated solution is optionally dried orotherwise treated to concentrate the sample and subsequently analyzedfor monosaccharide content by any suitable analytical technique (e.g.,HPLC, MS, GC, or the like with or without chemical or enzymaticderivatization before detection). This method can be used to detect MPSIIID disease, measure disease severity, or to measure response totherapy.

As discussed above, in certain embodiments, using the method describedherein, MPS IIID is diagnosed in an individual from a biological sampletaken therefrom. For example, in some embodiments, a biological sampleis optionally placed in to a defined MW cut off spin column (retainslarge molecules when spun), optionally washed (e.g., with 1 or morevolumes of water or buffer to remove free sulfate and/or N-acetylglucosamine 6-O sulfate), and treated with a hexosaminidase or heparinlyase (e.g., to liberate a glycan residual compound N-acetyl glucosamine6-O sulfate). In some embodiments, after incubation, the liberatedN-acetyl glucosamine 6-O sulfate is optionally isolated by washing thefree N-acetyl glucosamine 6-O sulfate (e.g., through a defined MW cutoff membrane or by any other suitable method). In some of suchembodiments, the free monosaccharide for detection and/or quantitationis present in the flow through. In certain embodiments, the resultingisolated solution is optionally dried or otherwise treated toconcentrate the sample and subsequently analyzed for monosaccharidecontent by any suitable analytical technique (e.g., HPLC, MS, GC, pHdetection, or the like with or without chemical or enzymaticderivatization before detection). This method can be used to detect MPSHID disease, measure disease severity, or to measure response totherapy.

MPS IVA is a human genetic disease caused by a deficiency in the enzymelysosomal enzyme galactose/N-acetyl galactosamine 6-O sulfatase. Thisenzyme is required in the lysosome to degrade glycans that contain6-O-sulfated galactose and 6-O sulfated N-acetyl galactosamine residues.Due to this enzymatic deficiency, glycans with 6-O-sulfated galactoseand 6-O sulfated N-acetyl galactosamine residues on the non-reducing endaccumulate to high levels (including chondroitin and keratan sulfate).In certain embodiments, using the method described herein, MPS IVA isdiagnosed in an individual from a biological sample taken therefrom. Forexample, in some embodiments, a biological sample is optionally placedin to a defined MW cut off spin column (retains large molecules whenspun), optionally washed (e.g., with 1 or more volumes of water orbuffer to remove free monosaccharide), and treated with a galactose6-O-sulfatase and/or an N-acetyl galactosamine 6-O sulfatase and agalactosidase and/or hexosaminidase (e.g., to liberate a glycan residualcompound Gal and/or GalNAc). In some embodiments, after incubation, theliberated monosaccharide is optionally isolated by washing the freemonosaccharide (e.g., through a defined MW cut off membrane or by anyother suitable method). In some of such embodiments, the freemonosaccharide for detection and/or quantitation is present in the flowthrough. In certain embodiments, the resulting isolated solution isoptionally dried or otherwise treated to concentrate the sample andsubsequently analyzed for monosaccharide content by any suitableanalytical technique (e.g., HPLC, MS, GC, or the like with or withoutchemical or enzymatic derivatization before detection). This method canbe used to detect MPS IVA disease, measure disease severity, or tomeasure response to therapy.

As discussed above, in certain embodiments, using the method describedherein, MPS IVA is diagnosed in an individual from a biological sampletaken therefrom. For example, in some embodiments, a biological sampleis optionally placed in to a defined MW cut off spin column (retainslarge molecules when spun), optionally washed (e.g., with 1 or morevolumes of water or buffer to remove free sulfate), and treated with a6-O-sulfatase capable of desulfating 6-O-sulfated galactose and/or 6-Osulfated N-acetyl galactosamine residues (e.g., to liberate a glycanresidual compound sulfate). In some embodiments, after incubation, theliberated sulfate is optionally isolated by washing the free sulfate(e.g., through a defined MW cut off membrane or by any other suitablemethod). In some of such embodiments, the free sulfate for detectionand/or quantitation is present in the flow through. In certainembodiments, the resulting isolated solution is optionally dried orotherwise treated to concentrate the sample and subsequently analyzedfor sulfate content by any suitable analytical technique (e.g., HPLC,MS, GC, pH detection, or the like with or without chemical or enzymaticderivatization before detection). This method can be used to detect MPSIVA disease, measure disease severity, or to measure response totherapy.

MPS IVB is a human genetic disease caused by a deficiency in the enzymelysosomal β-galactosidase. This enzyme is required in the lysosome todegrade glycans that contain galactose residues. Due to this enzymaticdeficiency, glycans with β-galactose residues on the non-reducing endaccumulate to high levels (including keratan sulfate and other glycans).In certain embodiments, using the method described herein, MPS IVB isdiagnosed in an individual from a biological sample taken therefrom. Forexample, in some embodiments, a biological sample is optionally placedin to a defined MW cut off spin column (retains large molecules whenspun), optionally washed (e.g., with 1 or more volumes of water orbuffer to remove free monosaccharide), and treated with a galactosidase(e.g., to liberate a glycan residual compound Gal). In some embodiments,after incubation, the liberated monosaccharide is optionally isolated bywashing the free monosaccharide (e.g., through a defined MW cut offmembrane or by any other suitable method). In some of such embodiments,the free monosaccharide for detection and/or quantitation is present inthe flow through. In certain embodiments, the resulting isolatedsolution is optionally dried or otherwise treated to concentrate thesample and subsequently analyzed for monosaccharide content by anysuitable analytical technique (e.g., HPLC, MS, GC, or the like with orwithout chemical or enzymatic derivatization before detection). Thismethod can be used to detect MPS IVB disease, measure disease severity,or to measure response to therapy.

MPS VI is a human genetic disease caused by a deficiency in the enzyme4-O sulfatase that desulfates N-acetyl galactosamine. This enzyme isrequired in the lysosome to degrade glycans that contain 4-O-sulfatedN-acetyl galactosamine residues. Due to this enzymatic deficiency,glycans with 4-O-sulfated N-acetyl galactosamine residues on thenon-reducing end accumulate to high levels (including chondroitinsulfate). In certain embodiments, using the method described herein, MPSVI is diagnosed in an individual from a biological sample takentherefrom. For example, in some embodiments, a biological sample isoptionally placed in to a defined MW cut off spin column (retains largemolecules when spun), optionally washed (e.g., with 1 or more volumes ofwater or buffer to remove free sulfate), and treated with a4-O-sulfatase that can desulfate 4-O-sulfated N-acetyl galactosamineresidues (e.g., to liberate a glycan residual compound sulfate). In someembodiments, after incubation, the liberated sulfate is optionallyisolated by washing the free sulfate (e.g., through a defined MW cut offmembrane or by any other suitable method). In some of such embodiments,the free sulfate for detection and/or quantitation is present in theflow through. In certain embodiments, the resulting isolated solution isoptionally dried or otherwise treated to concentrate the sample andsubsequently analyzed for sulfate content by any suitable analyticaltechnique (e.g., HPLC, MS, GC, pH detection, or the like with or withoutchemical or enzymatic derivatization before detection). This method canbe used to detect MPS VI disease, measure disease severity, or tomeasure response to therapy.

As discussed above, in certain embodiments, using the method describedherein, MPS VI is diagnosed in an individual from a biological sampletaken therefrom. For example, in some embodiments, a biological sampleis optionally placed in to a defined MW cut off spin column (retainslarge molecules when spun), optionally washed (e.g., with 1 or morevolumes of water or buffer to remove free N-acetyl galactosamine), andtreated with a 4-O-sulfatase that is capable of desulfating 4-O-sulfatedN-acetyl galactosamine residues then treated with a hexosaminidase(e.g., to liberate a glycan residual compound N-acetyl galactosamine).In some embodiments, after incubation, the liberated N-acetylgalactosamine is optionally isolated by washing the free monosaccharide(e.g., through a defined MW cut off membrane or by any other suitablemethod). In some of such embodiments, the free monosaccharide fordetection and/or quantitation is present in the flow through. In certainembodiments, the resulting isolated solution is optionally dried orotherwise treated to concentrate the sample and subsequently analyzedfor monosaccharide content by any suitable analytical technique (e.g.,HPLC, MS, GC, or the like with or without chemical or enzymaticderivatization before detection). This method can be used to detect MPSVI disease, measure disease severity, or to measure response to therapy.

MPS VII is a human genetic disease caused by a deficiency in thelysosomal enzyme beta-glucuronidase. This enzyme is required in thelysosome to degrade glycans that contain glucuronic acid residues. Dueto this enzymatic deficiency, glycans with glucuronic acid residues onthe non-reducing end accumulate to high levels (including chondroitinsulfate, heparan sulfate and others). In certain embodiments, using themethod described herein, MPS VII is diagnosed in an individual from abiological sample taken therefrom. For example, in some embodiments, abiological sample is optionally placed in to a defined MW cut off spincolumn (retains large molecules when spun), optionally washed (e.g.,with 1 or more volumes of water or buffer to remove free glucuronicacid), and treated with a glucuronidase (e.g., to liberate a glycanresidual compound glucuronic acid). In some embodiments, afterincubation, the liberated monosaccharide is optionally isolated bywashing the free monosaccharide (e.g., through a defined MW cut offmembrane or by any other suitable method). In some of such embodiments,the free monosaccharide for detection and/or quantitation is present inthe flow through. In certain embodiments, the resulting isolatedsolution is optionally dried or otherwise treated to concentrate thesample and subsequently analyzed for monosaccharide content by anysuitable analytical technique (e.g., HPLC, MS, GC, pH detection, or thelike with or without chemical or enzymatic derivatization beforedetection). This method can be used to detect MPS VII disease, measuredisease severity, or to measure response to therapy.

Methods described herein can also be used to define the relativepresence of different glycan classes.

Fabry Disease is a human genetic disease caused by a deficiency in thelysosomal α-galactosidase. Due to this enzymatic deficiency, glycanswith non-reducing end terminal α-galactose residues are abundant. Incertain embodiments, using the method described herein, Fabry Disease isdiagnosed in an individual from a biological sample taken therefrom. Forexample, in some embodiments, a biological sample is optionally placedin to a defined MW cut off spin column (retains large molecules whenspun), optionally washed (e.g., with 1 or more volumes of water orbuffer to remove free monosaccharide), and treated with a galactosidasethat is capable of liberating a non-reducing end monosaccharide (e.g.,to liberate a glycan residual compound). In some embodiments, afterincubation, the liberated glycan residual compound is optionallyisolated by washing the free glycan residual compound (e.g., through adefined MW cut off membrane or by any other suitable method). In some ofsuch embodiments, the free glycan residual compound for detection and/orquantitation is present in the flow through. In certain embodiments, theresulting isolated solution is optionally dried or otherwise treated toconcentrate the sample and subsequently analyzed for glycan residualcompound content by any suitable analytical technique (e.g., HPLC, MS,GC, pH detection, or the like with or without chemical or enzymaticderivatization before detection). This method can be used to detectFabry Disease, measure disease severity, or to measure response totherapy.

In some embodiments, as described in Table 1, other enzymes andprocesses are optionally utilized to diagnose other lysosomal storagediseases (LSDs). As described in the table, the appropriate enzyme(s)can be selected as appropriate for the specific disease.Oncology—Melanoma and Neuroblastoma via Sialic Acid

A hallmark of cancer is altered glycosylation. The changes inglycosylation are a reflection of changes in enzymes and factors thatregulate the biosynthesis, turnover, presentation, stability,solubility, and degradation of glycans. Many of these changes result inglycans being produced that have altered structures. The methodsdescribed here are utilized in various embodiments to evaluate thosestructural changes (e.g., measure abnormal glycan accumulation) that arepresent on the non-reducing end of the glycans present in individualssuffering from a cancerous disease.

Some examples of cancerous diseases suitable for diagnosis and/ormonitoring therapy according to methods described herein include, by wayof non-limiting example, melanoma and neuroblastoma. In some instances,such cancers have alterations in the biosynthesis, turnover,presentation, stability, solubility, or degradation of gangliosides. Insome instances, these sialic acid modified glycolipids are detectedand/or otherwise characterized or analyzed in a biological sample (e.g.,serum) of patients with these tumor types. In some embodiments, theabundance of the heterogeneous population of gangliosides is quantifiedto measuring sialic acid or other glycan residual released fromgangliosides in the blood.

Due to this enzymatic alteration, gangliosides and other glycans arepresent in the body at high levels. In certain embodiments, using themethod described herein, cancer (e.g., melanoma or neuroblastoma) isdiagnosed in an individual from a biological sample taken therefrom. Forexample, in some embodiments, a biological sample is optionally placedin to a defined MW cut off spin column (retains large molecules whenspun), optionally washed (e.g., with 1 or more volumes of water orbuffer to remove free sialic acid), and treated with a sialidase thatcan liberate sialic acid (e.g., to liberate a glycan residual compoundsialic acid). In some embodiments, after incubation, the liberatedsialic acid is optionally isolated by washing the free sialic acid(e.g., through a defined MW cut off membrane or by any other suitablemethod). In some of such embodiments, the free sialic acid for detectionand/or quantitation is present in the flow through. In certainembodiments, the resulting isolated solution is optionally dried orotherwise treated to concentrate the sample and subsequently analyzedfor sialic acid content by any suitable analytical technique (e.g.,HPLC, MS, GC, pH detection, or the like with or without chemical orenzymatic derivatization before detection). This method can be used todetect cancer (e.g., melanoma or neuroblastoma) disease, measure diseaseseverity, or to measure response to therapy.

Oncology—Myeloma Via Heparan Sulfate Nonreducing Ends

An example of a human cancer that is diagnosed and/or monitoredaccording to the methods described herein (i.e., by analyzing with sucha method the altered degradation of a glycan) is multiple myeloma. Incertain instances, multiple myeloma commonly produces heparanase.Heparanase is an endoglycosidase that cleaved heparan sulfate intosmaller fragments, exposing novel non-reducing end structures. Incertain embodiments described herein, the presence of these novelnon-reducing end structures are detected using any method describedherein (e.g., by incubating a biological sample with variousglycosidases or sulfatases to detect the presence of novel glycannon-reducing ends).

Due to this enzymatic alteration, glycans (including heparan sulfate andothers) are present in the body at high levels. In certain embodiments,using the method described herein, cancer (e.g., multiple myeloma) isdiagnosed in an individual from a biological sample taken therefrom. Forexample, in some embodiments, a biological sample is optionally placedin to a defined MW cut off spin column (retains large molecules whenspun), optionally washed (e.g., with 1 or more volumes of water orbuffer to remove free monosaccharides and/or sulfate), and treated witha sulfatase, iduronidase, glucuronidase, hexosaminidase, or lyase thatis capable of liberating a non-reducing end monosaccharide or sulfate.In some embodiments, after incubation, the liberated glycan residualcompound is optionally isolated by washing the free glycan residualcompound (e.g., through a defined MW cut off membrane or by any othersuitable method). In some of such embodiments, the free glycan residualcompound for detection and/or quantitation is present in the flowthrough. In certain embodiments, the resulting isolated solution isoptionally dried or otherwise treated to concentrate the sample andsubsequently analyzed for glycan residual compound content by anysuitable analytical technique (e.g., HPLC, MS, GC, pH detection, or thelike with or without chemical or enzymatic derivatization beforedetection). This method can be used to detect cancer (e.g., multiplemyeloma) disease, measure disease severity, or to measure response totherapy.

Oncology—Adenocarcinoma

Adenocarcinoma is associated with changes in glycosylation includingincreased sialylation and fucosylation. The described method can be usedto measure disease by analyzing glycans (total or purified or enrichedfor specific glycan classes) from a patient for the amount ofnonreducing end terminal sialic acid or fucose, by measuring the releaseof these glycan residuals after treatment with a sialidase orfucosidase.

Other Applications

As described in Tables 1-4, various diseases associated with changes inglycosylation are optionally diagnosed and/or monitored according tomethods described herein. Various disorders include, by way ofnon-limiting example, lysosomal storage disease, cancer, neurologicaldisease (dementia, Alzheimer's, etc), liver disease, bone disease,infectious diseases, and the like.

Provided herein are methods of diagnosing individuals (including, e.g.,a disease state or the severity of a disease states) with a lysosomalstorage disease (LSD) or methods of monitoring the treatment of alysosomal storage disease (LSD). Provided in Table 1 are specificembodiments of disease that are optionally diagnosed and/or monitoredaccording to various embodiments described herein. Table 1 alsoillustrates various non-limiting embodiments of specific enzyme(s) thatare optionally utilized to treat a biological sample from an individualsuffering from or suspected (e.g., through a pre- or preliminaryscreening process) of suffering from an LSD. Moreover, Table 1 furtherillustrates various glycan residual compounds that are liberated invarious embodiments described herein, such liberated glycan residualcompounds optionally being detected and/or measured in order to diagnoseand/or monitor a lysosomal storage disease (LSD).

TABLE 1 Exemplary LSD Uses Primary Secondary Glycan Non-ReducingReleasing Releasing Residual Disease End Structure Enzyme EnzymeCompound MPS I IdoA iduronidase IdoA MPS II IdoA-2-O sufate 2-sulfataseSulfate and GlcA-2-O sufate MPS II IdoA-2-O sufate 2-sulfataseIduronidase IdoA and/or and GlcA-2-O sufate and/or GlcA glucuronidaseMPS IIIA GlcN—N-sulfate N-sulfatase Sulfate MPS IIIA GlcN—N-sulfateN-sulfatase hexosaminidase GlcN MPS IIIA GlcN—N-sulfate N-sulfataseHeparin lyase GlcN MPS IIIA GlcN—N-sulfate N-sulfatase N-acetyl GlcNActransferase and hexosaminidase MPS IIIA GlcN—N-sulfate Heparin lyaseGlcN—N-sulfate MPS IIIB GlcNAc hexosaminidase GlcNAc MPS IIIB GlcNAcDeacetylase acetate MPS IIIB GlcNAc Heparin lyase GlcNAc MPS IIICGlcNAc-6-O sulfate 6-O sulfatase Sulfate MPS IIIC GlcNAc-6-O sulfate 6-Osulfatase hexosaminidase GlcNAc MPS IIIC GlcNAc-6-O sulfate 6-Osulfatase Heparin lyase GlcNAc MPS IIIC GlcNAc-6-O sulfate Heparin lyaseGlcNAc-6-O sulfate MPS IIID GlcN hexosaminidase GlcN MPS IIID GlcNHeparin lyase GlcN MPS IIID GlcN N-acetyl hexosaminidase GlcNActransferase MPS IVA Gal-6-O sulfate 6-O sulfatase Sulfate and GalNAc-6-Osulfate MPS IVA Gal-6-O sulfate galactosidase Gal-6-O sulfate andGalNAc-6-O sulfate MPS IVA Gal-6-O sulfate N-acetyl GalNAc-6-O sulfateand GalNAc-6-O galactosidase sulfate MPS IVA Gal-6-O sulfatehexosaminidase GalNAc-6-O sulfate and GalNAc-6-O sulfate MPS IVA Gal-6-Osulfate 6-O sulfatase galactosidase Gal and GalNAc-6-O sulfate MPS IVAGal-6-O sulfate 6-O sulfatase N-acetyl GalNAc and GalNAc-6-Ogalactosidase sulfate MPS IVB Gal Galactosidase Gal MPS VI GalNAc-4-O4-O sulfatase Sulfate sulfate MPS VI GalNAc-4-O 4-O sulfatasehexosaminidase GalNAc sulfate MPS VI GalNAc-4-O 4-O sulfataseChondroitin GalNAc sulfate lyase MPS VI GalNAc-4-O ChondroitinGalNAc-4-O sulfate lyase sulfate MPS VII GlcA β-glucuronidase GlcA AlphaMannosidosis Mannose Manosidase Man Aspartylglucosaminuria GlcNAchexosaminidase GlcNAc Fabry Galactose galactosidase Gal FucosidosisFucose fucosidase Fuc Galactosialidosis Galactose and/or GalactosidaseGal and/or Sialic acid and/or sialidase Sialic acid Gaucher glucoseglucosidase glucose GM1 gangliosidosis Beta-Galactose Beta- galactoseGalactosidase GM1 gangliosidosis Beta-Galactose Beta- HexosaminidaseGalNAc Galactosidase GM2 activator GalNAc hexosaminidase GalNAcdeficiency Sialidosis Sialic acid Sialidase Sialic acid SialidosisSialic acid Alpha 2,3 Sialic acid Sialidase Sialidosis Sialic acidAlphas 2,6 Sialic acid Sialidase Sialidosis Sialic acid Alphas 2,8Sialic acid Sialidase Krabbe Galactose galactosidase GalactoseMetachromatic Sulfated 3-O sulfatase Sulfate Leukodystrophygalactosylceramide Metachromatic Sulfated 3-O sulfatase galactosidaseGalactose Leukodystrophy galactosylceramide Mucolipidosis II Broad rangeof Any listed Any glycans enzyme monosaccharide or sulfate MucolipidosisIII Broad range of Any listed Any glycans enzyme monosaccharide orsulfate Mucolipidosis IV Broad range of Any listed Any glycans enzymemonosaccharide or sulfate Multiple Sulfatase Sulfated glycans sulfatasesulfate Deficiency Multiple Sulfatase Sulfated glycans sulfatase Anyglycosidase monosaccharide Deficiency Multiple Sulfatase Sulfatedglycans Any glycosidase Sulfated Deficiency monosaccharide GlycogenStorage glucose glucosidase glucose Disease (Pompe) Sandhoff GalNAchexosaminidase GalNAc Tay-Sachs GalNAc hexosaminidase GalNAc AB VariantGalNAc hexosaminidase GalNAc Schindler Disease Alpha-GalNAchexosaminidase GalNAc Salla Disease Sialic acid none Sialic Acid AlphaMannosidosis Alpha mannose mannosidase Mannose Beta Mannosidosis Betamannose mannosidase Mannose Globoid cell galactose galactosidasegalactose leukodystrophy

Provided herein are methods of diagnosing individuals (including, e.g.,a disease state or the severity of a disease states) with a cancerousdisease state or methods of monitoring the treatment of a cancer.Provided in Table 2 are specific embodiments of disease that areoptionally diagnosed and/or monitored according to various embodimentsdescribed herein. Table 2 also illustrates various non-limitingembodiments of specific enzyme(s) that are optionally utilized to treata biological sample from an individual suffering from or suspected of(e.g., through a pre- or preliminary screening process) suffering from acancerous disease state. Moreover, Table 2 further illustrates variousglycan residual compounds that are liberated in various embodimentsdescribed herein, such liberated glycan residual compounds optionallybeing detected and/or measured in order to diagnose and/or monitor acancerous disease state.

TABLE 2 Exemplary Oncology Uses Primary Secondary Glycan Non-ReducingLiberating Liberating Residual Cancer Type End Structure Enzyme EnzymeCompound Melanoma Sialic Acid Sialidase Sialic acid Melanoma Sialic AcidAlpha 2,8 Sialidase Sialic acid Melanoma Sialic Acid Alpha 2,3 SialidaseSialic acid Melanoma Sialic Acid Alpha 2,6 Sialidase Sialic acidMelanoma GalNAc Hexosaminidase GalNAc Melanoma GalNAc SialidaseHexosaminidase GalNAc Melanoma Sialic acid Hexosaminidase SialidaseSialic acid Melanoma Galactose galactosidase Galactose MelanomaGalactose sialidase galactosidase Galactose Melanoma Fucose fucosidaseFucose Melanoma Galactose Galactosidase Galactose Melanoma GlcNAchexosaminidase GlcNAc Melanoma Sulfate Sulfatase Sulfate MelanomaSulfated Sulfatase hexosaminidase GlcNAc hexose or GalNAc MelanomaSulfated Sulfatase Iduronidase or IdoA or uronic acid glucouronidaseGlcA Neuroblastoma Sialic Acid Sialidase Sialic acid NeuroblastomaSialic Acid Alpha 2,8 Sialidase Sialic acid Neuroblastoma Sialic AcidAlpha 2,3 Sialidase Sialic acid Neuroblastoma Sialic Acid Alpha 2,6Sialidase Sialic acid Neuroblastoma GalNAc Hexosaminidase GalNAcNeuroblastoma GalNAc Sialidase Hexosaminidase GalNAc NeuroblastomaSialic acid Hexosaminidase Sialidase Sialic acid Neuroblastoma Galactosegalactosidase Galactose Neuroblastoma Galactose sialidase galactosidaseGalactose Neuroblastoma Fucose fucosidase Fucose Neuroblastoma GalactoseGalactosidase Galactose Neuroblastoma GlcNAc hexosaminidase GlcNAcNeuroblastoma Sulfate Sulfatase Sulfate Neuroblastoma Sulfated Sulfatasehexosaminidase GlcNAc hexose or GalNAc Neuroblastoma Sulfated SulfataseIduronidase or IdoA or uronic acid glucouronidase GlcA AdenocarcinomaSialic Acid Sialidase Sialic acid Adenocarcinoma Sialic Acid Alpha 2,8Sialidase Sialic acid Adenocarcinoma Sialic Acid Alpha 2,3 SialidaseSialic acid Adenocarcinoma Sialic Acid Alpha 2,6 Sialidase Sialic acidAdenocarcinoma GalNAc Hexosaminidase GalNAc Adenocarcinoma GalNAcSialidase Hexosaminidase GalNAc Adenocarcinoma Sialic acidHexosaminidase Sialidase Sialic acid Adenocarcinoma Galactosegalactosidase Galactose Adenocarcinoma Galactose sialidase galactosidaseGalactose Adenocarcinoma Fucose fucosidase Fucose AdenocarcinomaGalactose Galactosidase Galactose Adenocarcinoma GlcNAc hexosaminidaseGlcNAc Adenocarcinoma Sulfate Sulfatase Sulfate Adenocarcinoma SulfatedSulfatase hexosaminidase GlcNAc hexose or GalNAc Adenocarcinoma SulfatedSulfatase Iduronidase or IdoA or uronic acid glucouronidase GlcA MyelomaSialic Acid Sialidase Sialic acid Myeloma Sialic Acid Alpha 2,8Sialidase Sialic acid Myeloma Sialic Acid Alpha 2,3 Sialidase Sialicacid Myeloma Sialic Acid Alpha 2,6 Sialidase Sialic acid Myeloma GalNAcHexosaminidase GalNAc Myeloma GalNAc Sialidase Hexosaminidase GalNAcMyeloma Sialic acid Hexosaminidase Sialidase Sialic acid MyelomaGalactose galactosidase Galactose Myeloma Galactose sialidasegalactosidase Galactose Myeloma Fucose fucosidase Fucose MyelomaGalactose Galactosidase Galactose Myeloma GlcNAc hexosaminidase GlcNAcMyeloma Sulfate Sulfatase Sulfate Myeloma Sulfated Sulfatasehexosaminidase GlcNAc hexose or GalNAc Myeloma Sulfated SulfataseIduronidase or IdoA or uronic acid glucouronidase GlcA Breast SialicAcid Sialidase Sialic acid Breast Sialic Acid Alpha 2,8 Sialidase Sialicacid Breast Sialic Acid Alpha 2,3 Sialidase Sialic acid Breast SialicAcid Alpha 2,6 Sialidase Sialic acid Breast GalNAc Hexosaminidase GalNAcBreast GalNAc Sialidase Hexosaminidase GalNAc Breast Sialic acidHexosaminidase Sialidase Sialic acid Breast Galactose galactosidaseGalactose Breast Galactose sialidase galactosidase Galactose BreastFucose fucosidase Fucose Breast Galactose Galactosidase Galactose BreastGlcNAc hexosaminidase GlcNAc Breast Sulfate Sulfatase Sulfate BreastSulfated Sulfatase hexosaminidase GlcNAc hexose or GalNAc BreastSulfated Sulfatase Iduronidase or IdoA or uronic acid glucouronidaseGlcA Ovarian Sialic Acid Sialidase Sialic acid Ovarian Sialic Acid Alpha2,8 Sialidase Sialic acid Ovarian Sialic Acid Alpha 2,3 Sialidase Sialicacid Ovarian Sialic Acid Alpha 2,6 Sialidase Sialic acid Ovarian GalNAcHexosaminidase GalNAc Ovarian GalNAc Sialidase Hexosaminidase GalNAcOvarian Sialic acid Hexosaminidase Sialidase Sialic acid OvarianGalactose galactosidase Galactose Ovarian Galactose sialidasegalactosidase Galactose Ovarian Fucose fucosidase Fucose OvarianGalactose Galactosidase Galactose Ovarian GlcNAc hexosaminidase GlcNAcOvarian Sulfate Sulfatase Sulfate Ovarian Sulfated Sulfatasehexosaminidase GlcNAc hexose or GalNAc Ovarian Sulfated SulfataseIduronidase or IdoA or uronic acid glucouronidase GlcA Stomach SialicAcid Sialidase Sialic acid Stomach Sialic Acid Alpha 2,8 SialidaseSialic acid Stomach Sialic Acid Alpha 2,3 Sialidase Sialic acid StomachSialic Acid Alpha 2,6 Sialidase Sialic acid Stomach GalNAcHexosaminidase GalNAc Stomach GalNAc Sialidase Hexosaminidase GalNAcStomach Sialic acid Hexosaminidase Sialidase Sialic acid StomachGalactose galactosidase Galactose Stomach Galactose sialidasegalactosidase Galactose Stomach Fucose fucosidase Fucose StomachGalactose Galactosidase Galactose Stomach GlcNAc hexosaminidase GlcNAcStomach Sulfate Sulfatase Sulfate Stomach Sulfated Sulfatasehexosaminidase GlcNAc hexose or GalNAc Stomach Sulfated SulfataseIduronidase or IdoA or uronic acid glucouronidase GlcA Lung Sialic AcidSialidase Sialic acid Lung Sialic Acid Alpha 2,8 Sialidase Sialic acidLung Sialic Acid Alpha 2,3 Sialidase Sialic acid Lung Sialic Acid Alpha2,6 Sialidase Sialic acid Lung GalNAc Hexosaminidase GalNAc Lung GalNAcSialidase Hexosaminidase GalNAc Lung Sialic acid HexosaminidaseSialidase Sialic acid Lung Galactose galactosidase Galactose LungGalactose sialidase galactosidase Galactose Lung Fucose fucosidaseFucose Lung Galactose Galactosidase Galactose Lung GlcNAc hexosaminidaseGlcNAc Lung Sulfate Sulfatase Sulfate Lung Sulfated Sulfatasehexosaminidase GlcNAc hexose or GalNAc Lung Sulfated SulfataseIduronidase or IdoA or uronic acid glucouronidase GlcA Pancreatic SialicAcid Sialidase Sialic acid Pancreatic Sialic Acid Alpha 2,8 SialidaseSialic acid Pancreatic Sialic Acid Alpha 2,3 Sialidase Sialic acidPancreatic Sialic Acid Alpha 2,6 Sialidase Sialic acid Pancreatic GalNAcHexosaminidase GalNAc Pancreatic GalNAc Sialidase Hexosaminidase GalNAcPancreatic Sialic acid Hexosaminidase Sialidase Sialic acid PancreaticGalactose galactosidase Galactose Pancreatic Galactose sialidasegalactosidase Galactose Pancreatic Fucose fucosidase Fucose PancreaticGalactose Galactosidase Galactose Pancreatic GlcNAc hexosaminidaseGlcNAc Pancreatic Sulfate Sulfatase Sulfate Pancreatic SulfatedSulfatase hexosaminidase GlcNAc hexose or GalNAc Pancreatic SulfatedSulfatase Iduronidase or IdoA or uronic acid glucouronidase GlcA OralSialic Acid Sialidase Sialic acid Oral Sialic Acid Alpha 2,8 SialidaseSialic acid Oral Sialic Acid Alpha 2,3 Sialidase Sialic acid Oral SialicAcid Alpha 2,6 Sialidase Sialic acid Oral GalNAc Hexosaminidase GalNAcOral GalNAc Sialidase Hexosaminidase GalNAc Oral Sialic acidHexosaminidase Sialidase Sialic acid Oral Galactose galactosidaseGalactose Oral Galactose sialidase galactosidase Galactose Oral Fucosefucosidase Fucose Oral Galactose Galactosidase Galactose Oral GlcNAchexosaminidase GlcNAc Oral Sulfate Sulfatase Sulfate Oral SulfatedSulfatase hexosaminidase GlcNAc hexose or GalNAc Oral Sulfated SulfataseIduronidase or IdoA or uronic acid glucouronidase GlcA Colorectal SialicAcid Sialidase Sialic acid Colorectal Sialic Acid Alpha 2,8 SialidaseSialic acid Colorectal Sialic Acid Alpha 2,3 Sialidase Sialic acidColorectal Sialic Acid Alpha 2,6 Sialidase Sialic acid Colorectal GalNAcHexosaminidase GalNAc Colorectal GalNAc Sialidase Hexosaminidase GalNAcColorectal Sialic acid Hexosaminidase Sialidase Sialic acid ColorectalGalactose galactosidase Galactose Colorectal Galactose sialidasegalactosidase Galactose Colorectal Fucose fucosidase Fucose ColorectalGalactose Galactosidase Galactose Colorectal GlcNAc hexosaminidaseGlcNAc Colorectal Sulfate Sulfatase Sulfate Colorectal SulfatedSulfatase hexosaminidase GlcNAc hexose or GalNAc Colorectal SulfatedSulfatase Iduronidase or IdoA or uronic acid glucouronidase GlcA KidneySialic Acid Sialidase Sialic acid Kidney Sialic Acid Alpha 2,8 SialidaseSialic acid Kidney Sialic Acid Alpha 2,3 Sialidase Sialic acid KidneySialic Acid Alpha 2,6 Sialidase Sialic acid Kidney GalNAc HexosaminidaseGalNAc Kidney GalNAc Sialidase Hexosaminidase GalNAc Kidney Sialic acidHexosaminidase Sialidase Sialic acid Kidney Galactose galactosidaseGalactose Kidney Galactose sialidase galactosidase Galactose KidneyFucose fucosidase Fucose Kidney Galactose Galactosidase Galactose KidneyGlcNAc hexosaminidase GlcNAc Kidney Sulfate Sulfatase Sulfate KidneySulfated Sulfatase hexosaminidase GlcNAc hexose or GalNAc KidneySulfated Sulfatase Iduronidase or IdoA or uronic acid glucouronidaseGlcA Bladder Sialic Acid Sialidase Sialic acid Bladder Sialic Acid Alpha2,8 Sialidase Sialic acid Bladder Sialic Acid Alpha 2,3 Sialidase Sialicacid Bladder Sialic Acid Alpha 2,6 Sialidase Sialic acid Bladder GalNAcHexosaminidase GalNAc Bladder GalNAc Sialidase Hexosaminidase GalNAcBladder Sialic acid Hexosaminidase Sialidase Sialic acid BladderGalactose galactosidase Galactose Bladder Galactose sialidasegalactosidase Galactose Bladder Fucose fucosidase Fucose BladderGalactose Galactosidase Galactose Bladder GlcNAc hexosaminidase GlcNAcBladder Sulfate Sulfatase Sulfate Bladder Sulfated Sulfatasehexosaminidase GlcNAc hexose or GalNAc Bladder Sulfated SulfataseIduronidase or IdoA or uronic acid glucouronidase GlcA Prostate SialicAcid Sialidase Sialic acid Prostate Sialic Acid Alpha 2,8 SialidaseSialic acid Prostate Sialic Acid Alpha 2,3 Sialidase Sialic acidProstate Sialic Acid Alpha 2,6 Sialidase Sialic acid Prostate GalNAcHexosaminidase GalNAc Prostate GalNAc Sialidase Hexosaminidase GalNAcProstate Sialic acid Hexosaminidase Sialidase Sialic acid ProstateGalactose galactosidase Galactose Prostate Galactose sialidasegalactosidase Galactose Prostate Fucose fucosidase Fucose ProstateGalactose Galactosidase Galactose Prostate GlcNAc hexosaminidase GlcNAcProstate Sulfate Sulfatase Sulfate Prostate Sulfated Sulfatasehexosaminidase GlcNAc hexose or GalNAc Prostate Sulfated SulfataseIduronidase or IdoA or uronic acid glucouronidase GlcA Uterine SialicAcid Sialidase Sialic acid Uterine Sialic Acid Alpha 2,8 SialidaseSialic acid Uterine Sialic Acid Alpha 2,3 Sialidase Sialic acid UterineSialic Acid Alpha 2,6 Sialidase Sialic acid Uterine GalNAcHexosaminidase GalNAc Uterine GalNAc Sialidase Hexosaminidase GalNAcUterine Sialic acid Hexosaminidase Sialidase Sialic acid UterineGalactose galactosidase Galactose Uterine Galactose sialidasegalactosidase Galactose Uterine Fucose fucosidase Fucose UterineGalactose Galactosidase Galactose Uterine GlcNAc hexosaminidase GlcNAcUterine Sulfate Sulfatase Sulfate Uterine Sulfated Sulfatasehexosaminidase GlcNAc hexose or GalNAc Uterine Sulfated SulfataseIduronidase or IdoA or uronic acid glucouronidase GlcA Thyroid SialicAcid Sialidase Sialic acid Thyroid Sialic Acid Alpha 2,8 SialidaseSialic acid Thyroid Sialic Acid Alpha 2,3 Sialidase Sialic acid ThyroidSialic Acid Alpha 2,6 Sialidase Sialic acid Thyroid GalNAcHexosaminidase GalNAc Thyroid GalNAc Sialidase Hexosaminidase GalNAcThyroid Sialic acid Hexosaminidase Sialidase Sialic acid ThyroidGalactose galactosidase Galactose Thyroid Galactose sialidasegalactosidase Galactose Thyroid Fucose fucosidase Fucose ThyroidGalactose Galactosidase Galactose Thyroid GlcNAc hexosaminidase GlcNAcThyroid Sulfate Sulfatase Sulfate Thyroid Sulfated Sulfatasehexosaminidase GlcNAc hexose or GalNAc Thyroid Sulfated SulfataseIduronidase or IdoA or uronic acid glucouronidase GlcA Liver Sialic AcidSialidase Sialic acid Liver Sialic Acid Alpha 2,8 Sialidase Sialic acidLiver Sialic Acid Alpha 2,3 Sialidase Sialic acid Liver Sialic AcidAlpha 2,6 Sialidase Sialic acid Liver GalNAc Hexosaminidase GalNAc LiverGalNAc Sialidase Hexosaminidase GalNAc Liver Sialic acid HexosaminidaseSialidase Sialic acid Liver Galactose galactosidase Galactose LiverGalactose sialidase galactosidase Galactose Liver Fucose fucosidaseFucose Liver Galactose Galactosidase Galactose Liver GlcNAchexosaminidase GlcNAc Liver Sulfate Sulfatase Sulfate Liver SulfatedSulfatase hexosaminidase GlcNAc hexose or GalNAc Liver SulfatedSulfatase Iduronidase or IdoA or uronic acid glucouronidase GlcAEsophagus Sialic Acid Sialidase Sialic acid Esophagus Sialic Acid Alpha2,8 Sialidase Sialic acid Esophagus Sialic Acid Alpha 2,3 SialidaseSialic acid Esophagus Sialic Acid Alpha 2,6 Sialidase Sialic acidEsophagus GalNAc Hexosaminidase GalNAc Esophagus GalNAc SialidaseHexosaminidase GalNAc Esophagus Sialic acid Hexosaminidase SialidaseSialic acid Esophagus Galactose galactosidase Galactose EsophagusGalactose sialidase galactosidase Galactose Esophagus Fucose fucosidaseFucose Esophagus Galactose Galactosidase Galactose Esophagus GlcNAchexosaminidase GlcNAc Esophagus Sulfate Sulfatase Sulfate EsophagusSulfated Sulfatase hexosaminidase GlcNAc hexose or GalNAc EsophagusSulfated Sulfatase Iduronidase or IdoA or uronic acid glucouronidaseGlcA Brain Sialic Acid Sialidase Sialic acid Brain Sialic Acid Alpha 2,8Sialidase Sialic acid Brain Sialic Acid Alpha 2,3 Sialidase Sialic acidBrain Sialic Acid Alpha 2,6 Sialidase Sialic acid Brain GalNAcHexosaminidase GalNAc Brain GalNAc Sialidase Hexosaminidase GalNAc BrainSialic acid Hexosaminidase Sialidase Sialic acid Brain Galactosegalactosidase Galactose Brain Galactose sialidase galactosidaseGalactose Brain Fucose fucosidase Fucose Brain Galactose GalactosidaseGalactose Brain GlcNAc hexosaminidase GlcNAc Brain Sulfate SulfataseSulfate Brain Sulfated Sulfatase hexosaminidase GlcNAc hexose or GalNAcBrain Sulfated Sulfatase Iduronidase or IdoA or uronic acidglucouronidase GlcA Lymphomas Sialic Acid Sialidase Sialic acidLymphomas Sialic Acid Alpha 2,8 Sialidase Sialic acid Lymphomas SialicAcid Alpha 2,3 Sialidase Sialic acid Lymphomas Sialic Acid Alpha 2,6Sialidase Sialic acid Lymphomas GalNAc Hexosaminidase GalNAc LymphomasGalNAc Sialidase Hexosaminidase GalNAc Lymphomas Sialic acidHexosaminidase Sialidase Sialic acid Lymphomas Galactose galactosidaseGalactose Lymphomas Galactose sialidase galactosidase GalactoseLymphomas Fucose fucosidase Fucose Lymphomas Galactose GalactosidaseGalactose Lymphomas GlcNAc hexosaminidase GlcNAc Lymphomas SulfateSulfatase Sulfate Lymphomas Sulfated Sulfatase hexosaminidase GlcNAchexose or GalNAc Lymphomas Sulfated Sulfatase Iduronidase or IdoA oruronic acid glucouronidase GlcA Leukemias Sialic Acid Sialidase Sialicacid Leukemias Sialic Acid Alpha 2,8 Sialidase Sialic acid LeukemiasSialic Acid Alpha 2,3 Sialidase Sialic acid Leukemias Sialic Acid Alpha2,6 Sialidase Sialic acid Leukemias GalNAc Hexosaminidase GalNAcLeukemias GalNAc Sialidase Hexosaminidase GalNAc Leukemias Sialic acidHexosaminidase Sialidase Sialic acid Leukemias Galactose galactosidaseGalactose Leukemias Galactose sialidase galactosidase GalactoseLeukemias Fucose fucosidase Fucose Leukemias Galactose GalactosidaseGalactose Leukemias GlcNAc hexosaminidase GlcNAc Leukemias SulfateSulfatase Sulfate Leukemias Sulfated Sulfatase hexosaminidase GlcNAchexose or GalNAc Leukemias Sulfated Sulfatase Iduronidase or IdoA oruronic acid glucouronidase GlcA

Provided herein are methods of diagnosing individuals (including, e.g.,a disease state or the severity of a disease states) with a diseasestate associated with abnormal glycan accumulation. Provided in Table 3are specific embodiments of disease that are optionally diagnosed and/ormonitored according to various embodiments described herein. Table 3also illustrates various non-limiting embodiments of specific enzyme(s)that are optionally utilized to treat a biological sample from anindividual suffering from or suspected of (e.g., through a pre- orpreliminary screening process) suffering from various disease statesassociated with abnormal glycan accumulation. Moreover, Table 3 furtherillustrates various glycan residual compounds that are liberated invarious embodiments described herein, such liberated glycan residualcompounds optionally being detected and/or measured in order to diagnoseand/or monitor various disease states.

TABLE 3 Non-Reducing Primary Secondary Glycan End Liberating LiberatingResidual Disease Structure Enzyme Enzyme Compound Alzheimers Sialic AcidSialidase Sialic acid Alzheimers Sialic Acid Alpha 2,8 Sialic acidSialidase Alzheimers Sialic Acid Alpha 2,3 Sialic acid SialidaseAlzheimers Sialic Acid Alpha 2,6 Sialic acid Sialidase Alzheimers GalNAcHexosaminidase GalNAc Alzheimers GalNAc Sialidase Hexosaminidase GalNAcAlzheimers Sialic acid Hexosaminidase Sialidase Sialic acid AlzheimersGalactose galactosidase Galactose Alzheimers Galactose sialidasegalactosidase Galactose Alzheimers Fucose fucosidase Fucose AlzheimersGalactose Galactosidase Galactose Alzheimers GlcNAc hexosaminidaseGlcNAc Alzheimers Sulfate Sulfatase Sulfate Alzheimers SulfatedSulfatase hexosaminidase GlcNAc or hexose GalNAc Alzheimers SulfatedSulfatase Iduronidase or IdoA or GlcA uronic acid glucuronidaseAmyotrophic Lateral Sialic Acid Sialidase Sialic acid SclerosisAmyotrophic Lateral Sialic Acid Alpha 2,8 Sialic acid SclerosisSialidase Amyotrophic Lateral Sialic Acid Alpha 2,3 Sialic acidSclerosis Sialidase Amyotrophic Lateral Sialic Acid Alpha 2,6 Sialicacid Sclerosis Sialidase Amyotrophic Lateral GalNAc HexosaminidaseGalNAc Sclerosis Amyotrophic Lateral GalNAc Sialidase HexosaminidaseGalNAc Sclerosis Amyotrophic Lateral Sialic acid HexosaminidaseSialidase Sialic acid Sclerosis Amyotrophic Lateral Galactosegalactosidase Galactose Sclerosis Amyotrophic Lateral Galactosesialidase galactosidase Galactose Sclerosis Amyotrophic Lateral Fucosefucosidase Fucose Sclerosis Amyotrophic Lateral Galactose GalactosidaseGalactose Sclerosis Amyotrophic Lateral GlcNAc hexosaminidase GlcNAcSclerosis Amyotrophic Lateral Sulfate Sulfatase Sulfate SclerosisAmyotrophic Lateral Sulfated Sulfatase hexosaminidase GlcNAc orSclerosis hexose GalNAc Amyotrophic Lateral Sulfated SulfataseIduronidase or IdoA or GlcA Sclerosis uronic acid glucuronidase CerebralPalsy Sialic Acid Sialidase Sialic acid Cerebral Palsy Sialic Acid Alpha2,8 Sialic acid Sialidase Cerebral Palsy Sialic Acid Alpha 2,3 Sialicacid Sialidase Cerebral Palsy Sialic Acid Alpha 2,6 Sialic acidSialidase Cerebral Palsy GalNAc Hexosaminidase GalNAc Cerebral PalsyGalNAc Sialidase Hexosaminidase GalNAc Cerebral Palsy Sialic acidHexosaminidase Sialidase Sialic acid Cerebral Palsy Galactosegalactosidase Galactose Cerebral Palsy Galactose sialidase galactosidaseGalactose Cerebral Palsy Fucose fucosidase Fucose Cerebral PalsyGalactose Galactosidase Galactose Cerebral Palsy GlcNAc hexosaminidaseGlcNAc Cerebral Palsy Sulfate Sulfatase Sulfate Cerebral Palsy SulfatedSulfatase hexosaminidase GlcNAc or hexose GalNAc Cerebral Palsy SulfatedSulfatase Iduronidase or IdoA or GlcA uronic acid glucuronidaseSchizophrenia Sialic Acid Sialidase Sialic acid Schizophrenia SialicAcid Alpha 2,8 Sialic acid Sialidase Schizophrenia Sialic Acid Alpha 2,3Sialic acid Sialidase Schizophrenia Sialic Acid Alpha 2,6 Sialic acidSialidase Schizophrenia GalNAc Hexosaminidase GalNAc SchizophreniaGalNAc Sialidase Hexosaminidase GalNAc Schizophrenia Sialic acidHexosaminidase Sialidase Sialic acid Schizophrenia Galactosegalactosidase Galactose Schizophrenia Galactose sialidase galactosidaseGalactose Schizophrenia Fucose fucosidase Fucose Schizophrenia GalactoseGalactosidase Galactose Schizophrenia GlcNAc hexosaminidase GlcNAcSchizophrenia Sulfate Sulfatase Sulfate Schizophrenia Sulfated Sulfatasehexosaminidase GlcNAc or hexose GalNAc Schizophrenia Sulfated SulfataseIduronidase or IdoA or GlcA uronic acid glucouronidase Bipolar DisorderSialic Acid Sialidase Sialic acid Bipolar Disorder Sialic Acid Alpha 2,8Sialic acid Sialidase Bipolar Disorder Sialic Acid Alpha 2,3 Sialic acidSialidase Bipolar Disorder Sialic Acid Alpha 2,6 Sialic acid SialidaseBipolar Disorder GalNAc Hexosaminidase GalNAc Bipolar Disorder GalNAcSialidase Hexosaminidase GalNAc Bipolar Disorder Sialic acidHexosaminidase Sialidase Sialic acid Bipolar Disorder Galactosegalactosidase Galactose Bipolar Disorder Galactose sialidasegalactosidase Galactose Bipolar Disorder Fucose fucosidase FucoseBipolar Disorder Galactose Galactosidase Galactose Bipolar DisorderGlcNAc hexosaminidase GlcNAc Bipolar Disorder Sulfate Sulfatase SulfateBipolar Disorder Sulfated Sulfatase hexosaminidase GlcNAc or hexoseGalNAc Bipolar Disorder Sulfated Sulfatase Iduronidase or IdoA or GlcAuronic acid glucouronidase Depression Sialic Acid Sialidase Sialic acidDepression Sialic Acid Alpha 2,8 Sialic acid Sialidase Depression SialicAcid Alpha 2,3 Sialic acid Sialidase Depression Sialic Acid Alpha 2,6Sialic acid Sialidase Depression GalNAc Hexosaminidase GalNAc DepressionGalNAc Sialidase Hexosaminidase GalNAc Depression Sialic acidHexosaminidase Sialidase Sialic acid Depression Galactose galactosidaseGalactose Depression Galactose sialidase galactosidase GalactoseDepression Fucose fucosidase Fucose Depression Galactose GalactosidaseGalactose Depression GlcNAc hexosaminidase GlcNAc Depression SulfateSulfatase Sulfate Depression Sulfated Sulfatase hexosaminidase GlcNAc orhexose GalNAc Depression Sulfated Sulfatase Iduronidase or IdoA or GlcAuronic acid glucouronidase Epilepsy Sialic Acid Sialidase Sialic acidEpilepsy Sialic Acid Alpha 2,8 Sialic acid Sialidase Epilepsy SialicAcid Alpha 2,3 Sialic acid Sialidase Epilepsy Sialic Acid Alpha 2,6Sialic acid Sialidase Epilepsy GalNAc Hexosaminidase GalNAc EpilepsyGalNAc Sialidase Hexosaminidase GalNAc Epilepsy Sialic acidHexosaminidase Sialidase Sialic acid Epilepsy Galactose galactosidaseGalactose Epilepsy Galactose sialidase galactosidase Galactose EpilepsyFucose fucosidase Fucose Epilepsy Galactose Galactosidase GalactoseEpilepsy GlcNAc hexosaminidase GlcNAc Epilepsy Sulfate Sulfatase SulfateEpilepsy Sulfated Sulfatase hexosaminidase GlcNAc or hexose GalNAcEpilepsy Sulfated Sulfatase Iduronidase or IdoA or GlcA uronic acidglucouronidase Migraine Sialic Acid Sialidase Sialic acid MigraineSialic Acid Alpha 2,8 Sialic acid Sialidase Migraine Sialic Acid Alpha2,3 Sialic acid Sialidase Migraine Sialic Acid Alpha 2,6 Sialic acidSialidase Migraine GalNAc Hexosaminidase GalNAc Migraine GalNAcSialidase Hexosaminidase GalNAc Migraine Sialic acid HexosaminidaseSialidase Sialic acid Migraine Galactose galactosidase GalactoseMigraine Galactose sialidase galactosidase Galactose Migraine Fucosefucosidase Fucose Migraine Galactose Galactosidase Galactose MigraineGlcNAc hexosaminidase GlcNAc Migraine Sulfate Sulfatase Sulfate MigraineSulfated Sulfatase hexosaminidase GlcNAc or hexose GalNAc MigraineSulfated Sulfatase Iduronidase or IdoA or GlcA uronic acidglucouronidase Multiple Sclerosis Sialic Acid Sialidase Sialic acidMultiple Sclerosis Sialic Acid Alpha 2,8 Sialic acid Sialidase MultipleSclerosis Sialic Acid Alpha 2,3 Sialic acid Sialidase Multiple SclerosisSialic Acid Alpha 2,6 Sialic acid Sialidase Multiple Sclerosis GalNAcHexosaminidase GalNAc Multiple Sclerosis GalNAc Sialidase HexosaminidaseGalNAc Multiple Sclerosis Sialic acid Hexosaminidase Sialidase Sialicacid Multiple Sclerosis Galactose galactosidase Galactose MultipleSclerosis Galactose sialidase galactosidase Galactose Multiple SclerosisFucose fucosidase Fucose Multiple Sclerosis Galactose GalactosidaseGalactose Multiple Sclerosis GlcNAc hexosaminidase GlcNAc MultipleSclerosis Sulfate Sulfatase Sulfate Multiple Sclerosis SulfatedSulfatase hexosaminidase GlcNAc or hexose GalNAc Multiple SclerosisSulfated Sulfatase Iduronidase or IdoA or GlcA uronic acidglucouronidase Parkinson's Sialic Acid Sialidase Sialic acid Parkinson'sSialic Acid Alpha 2,8 Sialic acid Sialidase Parkinson's Sialic AcidAlpha 2,3 Sialic acid Sialidase Parkinson's Sialic Acid Alpha 2,6 Sialicacid Sialidase Parkinson's GalNAc Hexosaminidase GalNAc Parkinson'sGalNAc Sialidase Hexosaminidase GalNAc Parkinson's Sialic acidHexosaminidase Sialidase Sialic acid Parkinson's Galactose galactosidaseGalactose Parkinson's Galactose sialidase galactosidase GalactoseParkinson's Fucose fucosidase Fucose Parkinson's Galactose GalactosidaseGalactose Parkinson's GlcNAc hexosaminidase GlcNAc Parkinson's SulfateSulfatase Sulfate Parkinson's Sulfated Sulfatase hexosaminidase GlcNAcor hexose GalNAc Parkinson's Sulfated Sulfatase Iduronidase or IdoA orGlcA uronic acid glucouronidase Rheumatoid Arthritis Sialic AcidSialidase Sialic acid Rheumatoid Arthritis Sialic Acid Alpha 2,8 Sialicacid Sialidase Rheumatoid Arthritis Sialic Acid Alpha 2,3 Sialic acidSialidase Rheumatoid Arthritis Sialic Acid Alpha 2,6 Sialic acidSialidase Rheumatoid Arthritis GalNAc Hexosaminidase GalNAc RheumatoidArthritis GalNAc Sialidase Hexosaminidase GalNAc Rheumatoid ArthritisSialic acid Hexosaminidase Sialidase Sialic acid Rheumatoid ArthritisGalactose galactosidase Galactose Rheumatoid Arthritis Galactosesialidase galactosidase Galactose Rheumatoid Arthritis Fucose fucosidaseFucose Rheumatoid Arthritis Galactose Galactosidase Galactose RheumatoidArthritis GlcNAc hexosaminidase GlcNAc Rheumatoid Arthritis SulfateSulfatase Sulfate Rheumatoid Arthritis Sulfated Sulfatase hexosaminidaseGlcNAc or hexose GalNAc Rheumatoid Arthritis Sulfated SulfataseIduronidase or IdoA or GlcA uronic acid glucouronidase PsoriaticArthritis Sialic Acid Sialidase Sialic acid Psoriatic Arthritis SialicAcid Alpha 2,8 Sialic acid Sialidase Psoriatic Arthritis Sialic AcidAlpha 2,3 Sialic acid Sialidase Psoriatic Arthritis Sialic Acid Alpha2,6 Sialic acid Sialidase Psoriatic Arthritis GalNAc HexosaminidaseGalNAc Psoriatic Arthritis GalNAc Sialidase Hexosaminidase GalNAcPsoriatic Arthritis Sialic acid Hexosaminidase Sialidase Sialic acidPsoriatic Arthritis Galactose galactosidase Galactose PsoriaticArthritis Galactose sialidase galactosidase Galactose PsoriaticArthritis Fucose fucosidase Fucose Psoriatic Arthritis GalactoseGalactosidase Galactose Psoriatic Arthritis GlcNAc hexosaminidase GlcNAcPsoriatic Arthritis Sulfate Sulfatase Sulfate Psoriatic ArthritisSulfated Sulfatase hexosaminidase GlcNAc or hexose GalNAc PsoriaticArthritis Sulfated Sulfatase Iduronidase or IdoA or GlcA uronic acidglucouronidase Asthma Sialic Acid Sialidase Sialic acid Asthma SialicAcid Alpha 2,8 Sialic acid Sialidase Asthma Sialic Acid Alpha 2,3 Sialicacid Sialidase Asthma Sialic Acid Alpha 2,6 Sialic acid Sialidase AsthmaGalNAc Hexosaminidase GalNAc Asthma GalNAc Sialidase HexosaminidaseGalNAc Asthma Sialic acid Hexosaminidase Sialidase Sialic acid AsthmaGalactose galactosidase Galactose Asthma Galactose sialidasegalactosidase Galactose Asthma Fucose fucosidase Fucose Asthma GalactoseGalactosidase Galactose Asthma GlcNAc hexosaminidase GlcNAc AsthmaSulfate Sulfatase Sulfate Asthma Sulfated Sulfatase hexosaminidaseGlcNAc or hexose GalNAc Asthma Sulfated Sulfatase Iduronidase or IdoA orGlcA uronic acid glucouronidase Chronic Obstructive Sialic AcidSialidase Sialic acid Pulmonary Disorder Chronic Obstructive Sialic AcidAlpha 2,8 Sialic acid Pulmonary Disorder Sialidase Chronic ObstructiveSialic Acid Alpha 2,3 Sialic acid Pulmonary Disorder Sialidase ChronicObstructive Sialic Acid Alpha 2,6 Sialic acid Pulmonary DisorderSialidase Chronic Obstructive GalNAc Hexosaminidase GalNAc PulmonaryDisorder Chronic Obstructive GalNAc Sialidase Hexosaminidase GalNAcPulmonary Disorder Chronic Obstructive Sialic acid HexosaminidaseSialidase Sialic acid Pulmonary Disorder Chronic Obstructive Galactosegalactosidase Galactose Pulmonary Disorder Chronic Obstructive Galactosesialidase galactosidase Galactose Pulmonary Disorder Chronic ObstructiveFucose fucosidase Fucose Pulmonary Disorder Chronic ObstructiveGalactose Galactosidase Galactose Pulmonary Disorder Chronic ObstructiveGlcNAc hexosaminidase GlcNAc Pulmonary Disorder Chronic ObstructiveSulfate Sulfatase Sulfate Pulmonary Disorder Chronic ObstructiveSulfated Sulfatase hexosaminidase GlcNAc or Pulmonary Disorder hexoseGalNAc Chronic Obstructive Sulfated Sulfatase Iduronidase or IdoA orGlcA Pulmonary Disorder uronic acid glucouronidase Lupus Sialic AcidSialidase Sialic acid Lupus Sialic Acid Alpha 2,8 Sialic acid SialidaseLupus Sialic Acid Alpha 2,3 Sialic acid Sialidase Lupus Sialic AcidAlpha 2,6 Sialic acid Sialidase Lupus GalNAc Hexosaminidase GalNAc LupusGalNAc Sialidase Hexosaminidase GalNAc Lupus Sialic acid HexosaminidaseSialidase Sialic acid Lupus Galactose galactosidase Galactose LupusGalactose sialidase galactosidase Galactose Lupus Fucose fucosidaseFucose Lupus Galactose Galactosidase Galactose Lupus GlcNAchexosaminidase GlcNAc Lupus Sulfate Sulfatase Sulfate Lupus SulfatedSulfatase hexosaminidase GlcNAc or hexose GalNAc Lupus SulfatedSulfatase Iduronidase or IdoA or GlcA uronic acid glucouronidaseHepatitis Sialic Acid Sialidase Sialic acid Hepatitis Sialic Acid Alpha2,8 Sialic acid Sialidase Hepatitis Sialic Acid Alpha 2,3 Sialic acidSialidase Hepatitis Sialic Acid Alpha 2,6 Sialic acid SialidaseHepatitis GalNAc Hexosaminidase GalNAc Hepatitis GalNAc SialidaseHexosaminidase GalNAc Hepatitis Sialic acid Hexosaminidase SialidaseSialic acid Hepatitis Galactose galactosidase Galactose HepatitisGalactose sialidase galactosidase Galactose Hepatitis Fucose fucosidaseFucose Hepatitis Galactose Galactosidase Galactose Hepatitis GlcNAchexosaminidase GlcNAc Hepatitis Sulfate Sulfatase Sulfate HepatitisSulfated Sulfatase hexosaminidase GlcNAc or hexose GalNAc HepatitisSulfated Sulfatase Iduronidase or IdoA or GlcA uronic acidglucouronidase Renal Disease Sialic Acid Sialidase Sialic acid RenalDisease Sialic Acid Alpha 2,8 Sialic acid Sialidase Renal Disease SialicAcid Alpha 2,3 Sialic acid Sialidase Renal Disease Sialic Acid Alpha 2,6Sialic acid Sialidase Renal Disease GalNAc Hexosaminidase GalNAc RenalDisease GalNAc Sialidase Hexosaminidase GalNAc Renal Disease Sialic acidHexosaminidase Sialidase Sialic acid Renal Disease Galactosegalactosidase Galactose Renal Disease Galactose sialidase galactosidaseGalactose Renal Disease Fucose fucosidase Fucose Renal Disease GalactoseGalactosidase Galactose Renal Disease GlcNAc hexosaminidase GlcNAc RenalDisease Sulfate Sulfatase Sulfate Renal Disease Sulfated Sulfatasehexosaminidase GlcNAc or hexose GalNAc Renal Disease Sulfated SulfataseIduronidase or IdoA or GlcA uronic acid glucouronidase Sickle CellDisease Sialic Acid Sialidase Sialic acid Sickle Cell Disease SialicAcid Alpha 2,8 Sialic acid Sialidase Sickle Cell Disease Sialic AcidAlpha 2,3 Sialic acid Sialidase Sickle Cell Disease Sialic Acid Alpha2,6 Sialic acid Sialidase Sickle Cell Disease GalNAc HexosaminidaseGalNAc Sickle Cell Disease GalNAc Sialidase Hexosaminidase GalNAc SickleCell Disease Sialic acid Hexosaminidase Sialidase Sialic acid SickleCell Disease Galactose galactosidase Galactose Sickle Cell DiseaseGalactose sialidase galactosidase Galactose Sickle Cell Disease Fucosefucosidase Fucose Sickle Cell Disease Galactose Galactosidase GalactoseSickle Cell Disease GlcNAc hexosaminidase GlcNAc Sickle Cell DiseaseSulfate Sulfatase Sulfate Sickle Cell Disease Sulfated Sulfatasehexosaminidase GlcNAc or hexose GalNAc Sickle Cell Disease SulfatedSulfatase Iduronidase or IdoA or GlcA uronic acid glucouronidaseFibromyalgia Sialic Acid Sialidase Sialic acid Fibromyalgia Sialic AcidAlpha 2,8 Sialic acid Sialidase Fibromyalgia Sialic Acid Alpha 2,3Sialic acid Sialidase Fibromyalgia Sialic Acid Alpha 2,6 Sialic acidSialidase Fibromyalgia GalNAc Hexosaminidase GalNAc Fibromyalgia GalNAcSialidase Hexosaminidase GalNAc Fibromyalgia Sialic acid HexosaminidaseSialidase Sialic acid Fibromyalgia Galactose galactosidase GalactoseFibromyalgia Galactose sialidase galactosidase Galactose FibromyalgiaFucose fucosidase Fucose Fibromyalgia Galactose Galactosidase GalactoseFibromyalgia GlcNAc hexosaminidase GlcNAc Fibromyalgia Sulfate SulfataseSulfate Fibromyalgia Sulfated Sulfatase hexosaminidase GlcNAc or hexoseGalNAc Fibromyalgia Sulfated Sulfatase Iduronidase or IdoA or GlcAuronic acid glucouronidase Irritable Bowel Sialic Acid Sialidase Sialicacid Syndrome Irritable Bowel Sialic Acid Alpha 2,8 Sialic acid SyndromeSialidase Irritable Bowel Sialic Acid Alpha 2,3 Sialic acid SyndromeSialidase Irritable Bowel Sialic Acid Alpha 2,6 Sialic acid SyndromeSialidase Irritable Bowel GalNAc Hexosaminidase GalNAc SyndromeIrritable Bowel GalNAc Sialidase Hexosaminidase GalNAc SyndromeIrritable Bowel Sialic acid Hexosaminidase Sialidase Sialic acidSyndrome Irritable Bowel Galactose galactosidase Galactose SyndromeIrritable Bowel Galactose sialidase galactosidase Galactose SyndromeIrritable Bowel Fucose fucosidase Fucose Syndrome Irritable BowelGalactose Galactosidase Galactose Syndrome Irritable Bowel GlcNAchexosaminidase GlcNAc Syndrome Irritable Bowel Sulfate Sulfatase SulfateSyndrome Irritable Bowel Sulfated Sulfatase hexosaminidase GlcNAc orSyndrome hexose GalNAc Irritable Bowel Sulfated Sulfatase Iduronidase orIdoA or GlcA Syndrome uronic acid glucouronidase Ulcer Sialic AcidSialidase Sialic acid Ulcer Sialic Acid Alpha 2,8 Sialic acid SialidaseUlcer Sialic Acid Alpha 2,3 Sialic acid Sialidase Ulcer Sialic AcidAlpha 2,6 Sialic acid Sialidase Ulcer GalNAc Hexosaminidase GalNAc UlcerGalNAc Sialidase Hexosaminidase GalNAc Ulcer Sialic acid HexosaminidaseSialidase Sialic acid Ulcer Galactose galactosidase Galactose UlcerGalactose sialidase galactosidase Galactose Ulcer Fucose fucosidaseFucose Ulcer Galactose Galactosidase Galactose Ulcer GlcNAchexosaminidase GlcNAc Ulcer Sulfate Sulfatase Sulfate Ulcer SulfatedSulfatase hexosaminidase GlcNAc or hexose GalNAc Ulcer SulfatedSulfatase Iduronidase or IdoA or GlcA uronic acid glucouronidaseIrritable Bowel Disease Sialic Acid Sialidase Sialic acid IrritableBowel Disease Sialic Acid Alpha 2,8 Sialic acid Sialidase IrritableBowel Disease Sialic Acid Alpha 2,3 Sialic acid Sialidase IrritableBowel Disease Sialic Acid Alpha 2,6 Sialic acid Sialidase IrritableBowel Disease GalNAc Hexosaminidase GalNAc Irritable Bowel DiseaseGalNAc Sialidase Hexosaminidase GalNAc Irritable Bowel Disease Sialicacid Hexosaminidase Sialidase Sialic acid Irritable Bowel DiseaseGalactose galactosidase Galactose Irritable Bowel Disease Galactosesialidase galactosidase Galactose Irritable Bowel Disease Fucosefucosidase Fucose Irritable Bowel Disease Galactose GalactosidaseGalactose Irritable Bowel Disease GlcNAc hexosaminidase GlcNAc IrritableBowel Disease Sulfate Sulfatase Sulfate Irritable Bowel Disease SulfatedSulfatase hexosaminidase GlcNAc or hexose GalNAc Irritable Bowel DiseaseSulfated Sulfatase Iduronidase or IdoA or GlcA uronic acidglucouronidase Coronary Artery Disease Sialic Acid Sialidase Sialic acidCoronary Artery Disease Sialic Acid Alpha 2,8 Sialic acid SialidaseCoronary Artery Disease Sialic Acid Alpha 2,3 Sialic acid SialidaseCoronary Artery Disease Sialic Acid Alpha 2,6 Sialic acid SialidaseCoronary Artery Disease GalNAc Hexosaminidase GalNAc Coronary ArteryDisease GalNAc Sialidase Hexosaminidase GalNAc Coronary Artery DiseaseSialic acid Hexosaminidase Sialidase Sialic acid Coronary Artery DiseaseGalactose galactosidase Galactose Coronary Artery Disease Galactosesialidase galactosidase Galactose Coronary Artery Disease Fucosefucosidase Fucose Coronary Artery Disease Galactose GalactosidaseGalactose Coronary Artery Disease GlcNAc hexosaminidase GlcNAc CoronaryArtery Disease Sulfate Sulfatase Sulfate Coronary Artery DiseaseSulfated Sulfatase hexosaminidase GlcNAc or hexose GalNAc CoronaryArtery Disease Sulfated Sulfatase Iduronidase or IdoA or GlcA uronicacid glucouronidase Restenosis Sialic Acid Sialidase Sialic acidRestenosis Sialic Acid Alpha 2,8 Sialic acid Sialidase Restenosis SialicAcid Alpha 2,3 Sialic acid Sialidase Restenosis Sialic Acid Alpha 2,6Sialic acid Sialidase Restenosis GalNAc Hexosaminidase GalNAc RestenosisGalNAc Sialidase Hexosaminidase GalNAc Restenosis Sialic acidHexosaminidase Sialidase Sialic acid Restenosis Galactose galactosidaseGalactose Restenosis Galactose sialidase galactosidase GalactoseRestenosis Fucose fucosidase Fucose Restenosis Galactose GalactosidaseGalactose Restenosis GlcNAc hexosaminidase GlcNAc Restenosis SulfateSulfatase Sulfate Restenosis Sulfated Sulfatase hexosaminidase GlcNAc orhexose GalNAc Restenosis Sulfated Sulfatase Iduronidase or IdoA or GlcAuronic acid glucouronidase Stroke Sialic Acid Sialidase Sialic acidStroke Sialic Acid Alpha 2,8 Sialic acid Sialidase Stroke Sialic AcidAlpha 2,3 Sialic acid Sialidase Stroke Sialic Acid Alpha 2,6 Sialic acidSialidase Stroke GalNAc Hexosaminidase GalNAc Stroke GalNAc SialidaseHexosaminidase GalNAc Stroke Sialic acid Hexosaminidase Sialidase Sialicacid Stroke Galactose galactosidase Galactose Stroke Galactose sialidasegalactosidase Galactose Stroke Fucose fucosidase Fucose Stroke GalactoseGalactosidase Galactose Stroke GlcNAc hexosaminidase GlcNAc StrokeSulfate Sulfatase Sulfate Stroke Sulfated Sulfatase hexosaminidaseGlcNAc or hexose GalNAc Stroke Sulfated Sulfatase Iduronidase or IdoA orGlcA uronic acid glucouronidase Diabetes Sialic Acid Sialidase Sialicacid Diabetes Sialic Acid Alpha 2,8 Sialic acid Sialidase DiabetesSialic Acid Alpha 2,3 Sialic acid Sialidase Diabetes Sialic Acid Alpha2,6 Sialic acid Sialidase Diabetes GalNAc Hexosaminidase GalNAc DiabetesGalNAc Sialidase Hexosaminidase GalNAc Diabetes Sialic acidHexosaminidase Sialidase Sialic acid Diabetes Galactose galactosidaseGalactose Diabetes Galactose sialidase galactosidase Galactose DiabetesFucose fucosidase Fucose Diabetes Galactose Galactosidase GalactoseDiabetes GlcNAc hexosaminidase GlcNAc Diabetes Sulfate Sulfatase SulfateDiabetes Sulfated Sulfatase hexosaminidase GlcNAc or hexose GalNAcDiabetes Sulfated Sulfatase Iduronidase or IdoA or GlcA uronic acidglucouronidase Hyperheparanemia Sialic Acid Sialidase Sialic acidHyperheparanemia Sialic Acid Alpha 2,8 Sialic acid SialidaseHyperheparanemia Sialic Acid Alpha 2,3 Sialic acid SialidaseHyperheparanemia Sialic Acid Alpha 2,6 Sialic acid SialidaseHyperheparanemia GalNAc Hexosaminidase GalNAc Hyperheparanemia GalNAcSialidase Hexosaminidase GalNAc Hyperheparanemia Sialic acidHexosaminidase Sialidase Sialic acid Hyperheparanemia Galactosegalactosidase Galactose Hyperheparanemia Galactose sialidasegalactosidase Galactose Hyperheparanemia Fucose fucosidase FucoseHyperheparanemia Galactose Galactosidase Galactose HyperheparanemiaGlcNAc hexosaminidase GlcNAc Hyperheparanemia Sulfate Sulfatase SulfateHyperheparanemia Sulfated Sulfatase hexosaminidase GlcNAc or hexoseGalNAc Hyperheparanemia Sulfated Sulfatase Iduronidase or IdoA or GlcAuronic acid glucouronidase Hypergangliosidemia Sialic Acid SialidaseSialic acid Hypergangliosidemia Sialic Acid Alpha 2,8 Sialic acidSialidase Hypergangliosidemia Sialic Acid Alpha 2,3 Sialic acidSialidase Hypergangliosidemia Sialic Acid Alpha 2,6 Sialic acidSialidase Hypergangliosidemia GalNAc Hexosaminidase GalNAcHypergangliosidemia GalNAc Sialidase Hexosaminidase GalNAcHypergangliosidemia Sialic acid Hexosaminidase Sialidase Sialic acidHypergangliosidemia Galactose galactosidase GalactoseHypergangliosidemia Galactose sialidase galactosidase GalactoseHypergangliosidemia Fucose fucosidase Fucose HypergangliosidemiaGalactose Galactosidase Galactose Hypergangliosidemia GlcNAchexosaminidase GlcNAc Hypergangliosidemia Sulfate Sulfatase SulfateHypergangliosidemia Sulfated Sulfatase hexosaminidase GlcNAc or hexoseGalNAc Hypergangliosidemia Sulfated Sulfatase Iduronidase or IdoA orGlcA uronic acid glucouronidase Hypermucinemia Sialic Acid SialidaseSialic acid Hypermucinemia Sialic Acid Alpha 2,8 Sialic acid SialidaseHypermucinemia Sialic Acid Alpha 2,3 Sialic acid SialidaseHypermucinemia Sialic Acid Alpha 2,6 Sialic acid SialidaseHypermucinemia GalNAc Hexosaminidase GalNAc Hypermucinemia GalNAcSialidase Hexosaminidase GalNAc Hypermucinemia Sialic acidHexosaminidase Sialidase Sialic acid Hypermucinemia Galactosegalactosidase Galactose Hypermucinemia Galactose sialidase galactosidaseGalactose Hypermucinemia Fucose fucosidase Fucose HypermucinemiaGalactose Galactosidase Galactose Hypermucinemia GlcNAc hexosaminidaseGlcNAc Hypermucinemia Sulfate Sulfatase Sulfate Hypermucinemia SulfatedSulfatase hexosaminidase GlcNAc or hexose GalNAc Hypermucinemia SulfatedSulfatase Iduronidase or IdoA or GlcA uronic acid glucouronidase HyperO-linked Sialic Acid Sialidase Sialic acid glycanemia Hyper O-linkedSialic Acid Alpha 2,8 Sialic acid glycanemia Sialidase Hyper O-linkedSialic Acid Alpha 2,3 Sialic acid glycanemia Sialidase Hyper O-linkedSialic Acid Alpha 2,6 Sialic acid glycanemia Sialidase Hyper O-linkedGalNAc Hexosaminidase GalNAc glycanemia Hyper O-linked GalNAc SialidaseHexosaminidase GalNAc glycanemia Hyper O-linked Sialic acidHexosaminidase Sialidase Sialic acid glycanemia Hyper O-linked Galactosegalactosidase Galactose glycanemia Hyper O-linked Galactose sialidasegalactosidase Galactose glycanemia Hyper O-linked Fucose fucosidaseFucose glycanemia Hyper O-linked Galactose Galactosidase Galactoseglycanemia Hyper O-linked GlcNAc hexosaminidase GlcNAc glycanemia HyperO-linked Sulfate Sulfatase Sulfate glycanemia Hyper O-linked SulfatedSulfatase hexosaminidase GlcNAc or glycanemia hexose GalNAc HyperO-linked Sulfated Sulfatase Iduronidase or IdoA or GlcA glycanemiauronic acid glucouronidase Hyper N-linked Sialic Acid Sialidase Sialicacid glycanemia Hyper N-linked Sialic Acid Alpha 2,8 Sialic acidglycanemia Sialidase Hyper N-linked Sialic Acid Alpha 2,3 Sialic acidglycanemia Sialidase Hyper N-linked Sialic Acid Alpha 2,6 Sialic acidglycanemia Sialidase Hyper N-linked GalNAc Hexosaminidase GalNAcglycanemia Hyper N-linked GalNAc Sialidase Hexosaminidase GalNAcglycanemia Hyper N-linked Sialic acid Hexosaminidase Sialidase Sialicacid glycanemia Hyper N-linked Galactose galactosidase Galactoseglycanemia Hyper N-linked Galactose sialidase galactosidase Galactoseglycanemia Hyper N-linked Fucose fucosidase Fucose glycanemia HyperN-linked Galactose Galactosidase Galactose glycanemia Hyper N-linkedGlcNAc hexosaminidase GlcNAc glycanemia Hyper N-linked Sulfate SulfataseSulfate glycanemia Hyper N-linked Sulfated Sulfatase hexosaminidaseGlcNAc or glycanemia hexose GalNAc Hyper N-linked Sulfated SulfataseIduronidase or IdoA or GlcA glycanemia uronic acid glucouronidaseHypersialylemia Sialic Acid Sialidase Sialic acid Hypersialylemia SialicAcid Alpha 2,8 Sialic acid Sialidase Hypersialylemia Sialic Acid Alpha2,3 Sialic acid Sialidase Hypersialylemia Sialic Acid Alpha 2,6 Sialicacid Sialidase Hypersialylemia GalNAc Hexosaminidase GalNAcHypersialylemia GalNAc Sialidase Hexosaminidase GalNAc HypersialylemiaSialic acid Hexosaminidase Sialidase Sialic acid HypersialylemiaGalactose galactosidase Galactose Hypersialylemia Galactose sialidasegalactosidase Galactose Hypersialylemia Fucose fucosidase FucoseHypersialylemia Galactose Galactosidase Galactose Hypersialylemia GlcNAchexosaminidase GlcNAc Hypersialylemia Sulfate Sulfatase SulfateHypersialylemia Sulfated Sulfatase hexosaminidase GlcNAc or hexoseGalNAc Hypersialylemia Sulfated Sulfatase Iduronidase or IdoA or GlcAuronic acid glucouronidase Hyperfucosylemia Sialic Acid Sialidase Sialicacid Hyperfucosylemia Sialic Acid Alpha 2,8 Sialic acid SialidaseHyperfucosylemia Sialic Acid Alpha 2,3 Sialic acid SialidaseHyperfucosylemia Sialic Acid Alpha 2,6 Sialic acid SialidaseHyperfucosylemia GalNAc Hexosaminidase GalNAc Hyperfucosylemia GalNAcSialidase Hexosaminidase GalNAc Hyperfucosylemia Sialic acidHexosaminidase Sialidase Sialic acid Hyperfucosylemia Galactosegalactosidase Galactose Hyperfucosylemia Galactose sialidasegalactosidase Galactose Hyperfucosylemia Fucose fucosidase FucoseHyperfucosylemia Galactose Galactosidase Galactose HyperfucosylemiaGlcNAc hexosaminidase GlcNAc Hyperfucosylemia Sulfate Sulfatase SulfateHyperfucosylemia Sulfated Sulfatase hexosaminidase GlcNAc or hexoseGalNAc Hyperfucosylemia Sulfated Sulfatase Iduronidase or IdoA or GlcAuronic acid glucouronidase Hypersulfogycanemia Sialic Acid SialidaseSialic acid Hypersulfogycanemia Sialic Acid Alpha 2,8 Sialic acidSialidase Hypersulfogycanemia Sialic Acid Alpha 2,3 Sialic acidSialidase Hypersulfogycanemia Sialic Acid Alpha 2,6 Sialic acidSialidase Hypersulfogycanemia GalNAc Hexosaminidase GalNAcHypersulfogycanemia GalNAc Sialidase Hexosaminidase GalNAcHypersulfogycanemia Sialic acid Hexosaminidase Sialidase Sialic acidHypersulfogycanemia Galactose galactosidase GalactoseHypersulfogycanemia Galactose sialidase galactosidase GalactoseHypersulfogycanemia Fucose fucosidase Fucose HypersulfogycanemiaGalactose Galactosidase Galactose Hypersulfogycanemia GlcNAchexosaminidase GlcNAc Hypersulfogycanemia Sulfate Sulfatase SulfateHypersulfogycanemia Sulfated Sulfatase hexosaminidase GlcNAc or hexoseGalNAc Hypersulfogycanemia Sulfated Sulfatase Iduronidase or IdoA orGlcA uronic acid glucouronidase

Provided herein are methods of diagnosing individuals (including, e.g.,a disease state or the severity of a disease states) with an infectiousdisease state associated with abnormal glycan accumulation. Provided inTable 4 are specific embodiments of disease that are optionallydiagnosed and/or monitored according to various embodiments describedherein. Table 4 also illustrates various non-limiting embodiments ofspecific enzyme(s) that are optionally utilized to treat a biologicalsample from an individual suffering from or suspected of (e.g., througha pre- or preliminary screening process) suffering from variousinfectious disease states associated with abnormal glycan accumulation.Moreover, Table 4 further illustrates various glycan residual compoundsthat are liberated in various embodiments described herein, suchliberated glycan residual compounds optionally being detected and/ormeasured in order to diagnose and/or monitor various infectious diseasestates.

TABLE 4 Infectious Diseases Non-Reducing Primary Secondary Glycan endLiberating Liberating Residual Disease structure Enzyme Enzyme CompoundBacterial Infections Mannose Mannosidase Mannose Bacterial InfectionsFucose Fucosidase Fucose Bacterial Infections Glucose GlucosidaseGlucose Bacterial Infections Galactose Galactosidase Galactose BacterialInfections GlcNAc hexosaminidase GlcNAc Bacterial Infections GalNAchexosaminidase GalNAc Bacterial Infections Arabinose ArabinosidaseArabinose Bacterial Infections Xylose Xylosidase Xylose BacterialInfections Ribose Ribosidase Ribose Bacterial Infections LyxoseLyxosidase Lyxose Bacterial Infections Talose Talosidase TaloseBacterial Infections Idose Idosidase Idose Bacterial Infections GuloseGulosidase Gulose Bacterial Infections Altrose Altrosidase AltroseBacterial Infections Allose Allosidase Allose Fungal Infections MannoseMannosidase Mannose Fungal Infections Fucose Fucosidase Fucose FungalInfections Glucose Glucosidase Glucose Fungal Infections GalactoseGalactosidase Galactose Fungal Infections GlcNAc hexosaminidase GlcNAcFungal Infections GalNAc hexosaminidase GalNAc Fungal InfectionsArabinose Arabinosidase Arabinose Fungal Infections Xylose XylosidaseXylose Fungal Infections Ribose Ribosidase Ribose Fungal InfectionsLyxose Lyxosidase Lyxose Fungal Infections Talose Talosidase TaloseFungal Infections Idose Idosidase Idose Fungal Infections GuloseGulosidase Gulose Fungal Infections Altrose Altrosidase Altrose FungalInfections Allose Allosidase Allose Viral Infections Sialic AcidSialidase Sialic acid Viral Infections Sialic Acid Alpha 2,8 Sialic acidSialidase Viral Infections Sialic Acid Alpha 2,3 Sialic acid SialidaseViral Infections Sialic Acid Alpha 2,6 Sialic acid Sialidase ViralInfections GalNAc Hexosaminidase GalNAc Viral Infections GalNAcSialidase Hexosaminidase GalNAc Viral Infections Sialic acidHexosaminidase Sialidase Sialic acid Viral Infections Galactosegalactosidase Galactose Viral Infections Galactose sialidasegalactosidase Galactose Viral Infections Fucose fucosidase Fucose ViralInfections Galactose Galactosidase Galactose Viral Infections GlcNAchexosaminidase GlcNAc Viral Infections Sulfate Sulfatase Sulfate ViralInfections Sulfated hexose Sulfatase hexosaminidase GlcNAc or GalNAcViral Infections Sulfated uronic Sulfatase Iduronidase or IdoA or GlcAacid glucouronidase

FIG. 1 illustrates compounds present in a normal biological sample notsubject to an enzymatic glycan residual liberation process describedherein. FIG. 2 illustrates compounds present in a normal biologicalsubject to an enzymatic glycan residual liberation process describedherein. FIG. 3 illustrates compounds present in a biological sample ofan individual suffering from a disorder associated with abnormal glycanaccumulation not subject to an enzymatic glycan residual liberationprocess described herein. FIG. 4 illustrates compounds present in abiological sample of an individual suffering from a disorder associatedwith abnormal glycan accumulation subject to an enzymatic glycanresidual liberation process described herein.

Detecting and Measuring:

Glycan residual compounds (including, e.g., oligosaccharides,monosaccharides, sulfate, phosphate, sialic acid, acetate, or the like)described herein are detected and/or measured in processes describedherein in any suitable manner. In some embodiments, glycan residualcompounds are detected and/or measured in unmodified form. In otherembodiments, glycan residual compounds are tagged with a detectablelabel prior and the labeled glycan residual compound is detected.

In some embodiments, non-labeled compounds are optionally detectedand/or measured in any suitable manner, e.g., by pH, by quantitativenuclear magnetic resonance (NMR), or the like.

In various embodiments, a method described herein comprises determiningwhether the amount of liberated glycan residue is abnormal and such adetermination comprises labeling the glycan residue with a detectablelabel and measuring the amount of labeled glycan residue with ananalytical instrument. In specific embodiments, the detectable label isa mass label, a radioisotope label, a fluorescent label, a chromophorelabel, or affinity label. In some embodiments, the amount of liberatedglycan is measured using UV-Vis spectroscopy, IR spectroscopy, massspectrometry, or a combination thereof.

In the various embodiments of any process or method described herein,any suitable detectable label is optionally utilized. In someembodiments, detectable labels useful in the processes or methodsdescribed herein include, by way of non-limiting example, mass labels,antibodies, affinity labels, radioisotope labels, chromophores,fluorescent labels, or the like.

Fluorescent labels suitable for use in various embodiments hereininclude, by way of non-limiting example, 2-aminopyridine (2-AP),2-aminobenzoic acid (2-AA), 2-aminobenzamide (2-AB), 2-aminoacridone(AMAC), p-aminobenzoic acid ethyl ester (ABEE), p-aminobenzonitrile(ABN), 2-amino-6-cyanoethylpyridine (ACP), 7-amino-4-methylcoumarine(AMC), 8-aminonaphthalene-1,3,6-trisulfate (ANTS),7-aminonaphthalene-1,3-disulfide (ANDS), and8-aminopyrene-1,3,6-trisulfate (APTS), or the like. The fluorescentlabels can be attached by reductive amination with the fluorescent labeland sodium cyanoborohydride or the like.

Mass labels suitable for use in various embodiments herein include, byway of non-limiting example, D-2-anthranilic acid, D-2-aminopyridine,D-methyl iodide, ¹³C methyl iodide, deuterated-pyridyl-amine, D-biotinor the like. The mass labels can be attached by permethylation orreductive amination by any method that is known to those of skill in theart.

Affinity labels suitable for use in various embodiments herein include,by way of non-limiting example, biotin and derivatives.

Radioisotope labels suitable for use in various embodiments hereininclude, by way of non-limiting example, sodium borotritide (NaB³H₄),³H, ¹⁴C, ³²P, ³⁵S, or the like.

Chromophores suitable for use in various embodiments herein include, byway of non-limiting example, 4-amino-1,1′-azobenzene,4′-N,N-dimethylamino-4-aminoazobenzene, aminoazobenzene,diaminoazobenzene, Direct Red 16, CI Acid Red 57, CI Acid Blue 45, CIAcid Blue 22, CL Mordant Brown 13, CI Direct Orange 75, or the like. Thechromophores may be labeled by any method that is known to those ofskill in the art, such as reductive amination with the chromophore andsodium cyanoborohydride.

In some embodiments, the detectable label is an antibody. In specificembodiments, the antibody is attached to a detectable compound, such asmass labels, radioisotope labels, chromophores, fluorescent labels, orthe like. In some embodiments, antibodies are themselves detected and/orare detectable in various manners, e.g., as a chromophore, afluorophore, or the like; or with a probe (e.g., using dot blottechniques, immune-detection techniques, or the like).

In certain embodiments, detectable labels are detected and/or quantifiedaccording to any process described herein using any technique,particularly any technique suitable for the detectable label utilized.In some embodiments, suitable detection techniques include, by way ofnon-limiting example, one or more of a mass spectrometer, a nuclearmagnetic resonance spectrometer, a UV-Vis spectrometer, an IRspectrometer, a fluorimeter, a phosphorimeter, a radiation spectrometer(e.g., a scintillation counter), a thin layer chromatographic technique,or the like. In certain embodiments, in any process described herein,glycan residual compounds are optionally directly detected using asuitable technique, such as quantitative nuclear magnetic resonance.Quantitative nuclear magnetic resonance is also optionally utilized toquantify and/or detect the presence of a detectable label. In certainembodiments, one or more glycan residual compounds are optionallydetected using a suitable liquid chromatography mass spectrometer(LC-MS).

In some embodiments, glycan residual compounds are tagged with anantibody or probe, and are quantified using any suitable method (e.g.,dot blot techniques, immune detection techniques (e.g., ELISA), or thelike).

Various analytical methods useful for the processes described hereininclude, by way of non-limiting example, mass spectrometry,chromatography, HPLC, UPLC, TLC, GC, HPAEC-PAD,electrophoresis—capillary or gel, or the like. In certain embodiments,wherein a chromatographic technique is utilized, any suitable solventsystem is optionally employed. In certain embodiments, a column (e.g.,Cosmogel DEAE, Tsk Gel DEAE, Cosmogel QA, Cosmogel CM, Cosmogel SP, orthe like) is optionally loaded with an equilibrating solvent (e.g., abuffer or salt solution, such as a potassium acetate solution, sodiumchloride solution, sodium acetate solution, ammonium acetate solution,or the like), e.g., with a pH of about 6, 7, or 8. In some embodiments,the buffer or salt solution has a concentration of about 10 mM, 20 mM,30 mM, 50 mM, 100 mM, 500 mM, 1 M, 2 M, or the like. Any suitable flowrate is used, e.g., 0.5 mL/min, 1 mL, min, 1.5 mL/min, 2 mL/min, or thelike. Following equilibration, a linear gradient is optionally utilized.In some embodiments, the linear gradient is run over 1-20 min, 1-10 min,10-20 min, 1-5 min, 5-10 min, or the like. In certain embodiments, thegradient is a buffer or salt solution, e.g., as described above (e.g.,from 0 M to 0.5 M, from 0 M to 3 M, from 0.5 M to 2 M, from 0 M to 2 M,from 1 M to 2 M, from 0 M to 3 M, from 2 M to 0 M, from 3 M to 0 M, orthe like). Once the gradient has reached a final concentration, theeluent is optionally held at the final concentration for a suitableperiod of time (e.g., 1-20 min, 5-10 min, 10-15 min, 1-5 min, 1-10 min,15-20 min, or the like). After the optional holding of the finalconcentration, the eluent may be switched to a second solvent or solventsystem (e.g., an alcohol, such as methanol, ethanol, or isopropanol,acetonitrile, water, or the like). The switch to the second solventsystem may be over a period of time, e.g., 15 seconds, 30 seconds, 45seconds, 60 seconds, 2 min, 3 min, or the like. The second solventsystem is optionally held for a period of time, such as 1 min, 2 min, 3min, 4 min, 5 min, 6 min, or the like. Following the second solventsystem cycle, the column is optionally restored to initial solventconditions.

Purification:

In certain embodiments, methods described herein comprise purifying abiological sample, e.g., to remove non-glycan compounds from thebiological sample. In some embodiments, a biological sample is purifiedprior to transforming a glycan thereof

In certain embodiments, a biological sample containing glycans (purifiedor not) can also be prepared so that all free glycan residual compounds(e.g., monosaccharides) that are naturally present in the biologicalsample (i.e., as taken from an individual and without being treated) areeliminated from the sample to reduce background signal (for exampleusing dialysis, spin column, gel filtration, etc).

In some embodiments, any process described herein includes a step ofpurifying a biological sample comprising removing monosaccharidestherefrom, removing sulfates therefrom, removing phosphates therefrom,removing acetate therefrom, removing sialic acid therefrom, or acombination thereof. For example, in some embodiments, a biologicalsample is optionally placed in to a defined MW cut off spin column(retains large molecules when spun), optionally washed (e.g., with 1 ormore volumes of water or buffer), and/or the like.

In certain embodiments, purification of biological samples may furtheror alternatively comprise, e.g., fractionation, purification,enrichment, or the like of glycans contained therein. In some instances,such purification techniques are suitable to isolate and/or separatedifferent glycan classes within the biological sample prior totransformation of one or more of such glycans. In more specificinstances, such purification techniques are used to isolate and/orseparate different subsets of a single glycan class (such as isolatingcomplex N-linked glycans from hybrid N-linked structures) prior totransformation of one or more of such glycans. In certain embodiments, abiological sample is optionally prepared in such a way to enrich forspecific glycan classes. For example, a PHA affinity column isoptionally used to isolate a sub-fraction of complex N-linked glycanswhile a Con A column could be used to enrich in a different subset ofN-linked glycans.

In some embodiments, any process described herein comprises purificationof a glycan residual compound resulting from a process described herein(e.g., purification of the glycan residual compound prior to analysisthereof). For example, in some embodiments, the glycan residual compoundis optionally isolated by any suitable process, such as by washing thefree glycan residual compound (e.g., through a defined MW cut offmembrane or by any other suitable method). Moreover, in certainembodiments, the resulting isolated glycan residual compound containingcomposition is optionally dried or otherwise treated to concentrate thesample and subsequently analyzed for glycan residual compound content byany suitable analytical technique.

In some embodiments, the processes described herein comprises furthertreatment steps of the test and/or control samples. For example, in someembodiments, the samples are homogenized and/or purified. In specificembodiments homogenization is achieved in any suitable manner including,by way of non-limiting example, with a basic solution, sonication,tissue grinding, or other chemical agents. In some embodiments, severityof a disorder is determined if a certain threshold amount is measured(e.g., as compared to a control or controls) or a threshold signal(e.g., on a fluorimeter or other analytical device utilized to detectand/or measure the generated biomarker). Similarly, a carrier of adisorder described herein is, in certain embodiments, determined if acertain threshold amount is measured (e.g., as compared to a control orcontrols) or a threshold signal (e.g., on a fluorimeter or otheranalytical device utilized to detect and/or measure the generatedbiomarker).

In certain embodiments, samples, including test samples and/or controlsamples, described herein are optionally purified prior to glycanprocessing (e.g., lyase treatment) and/or characterization. Test samplesand/or control samples (i.e., one or more or all of the glycans foundtherein) are optionally purified using any suitable purificationtechnique. Test samples and/or control samples are optionally purifiedat any suitable point in a process described herein, including before orafter tagging of the glycans founds within the sample. In certainembodiments, purification techniques include centrifugation,electrophoresis, chromatography (e.g., silica gel or alumina columnchromatography), gas chromatography, high performance liquidchromatography (HPLC) (e.g., reverse phase HPLC on chiral or achiralcolumns), thin layer chromatography, ion exchange chromatography, gelchromatography (e.g., gel filtration or permeation or size exclusionchromatography, gel electrophoresis), molecular sieve chromatography,affinity chromatography, size exclusion, filtration (e.g. through aflorisil or activated charcoal plug), precipitation, osmosis,recrystallization, fluorous phase purification, distillation,extraction, chromatofocusing, supercritical fluid extraction,preparative flash chromatography (e.g., flash chromatography using aUV-Vis detector and/or a mass spectrometer (e.g., using the Biotage®suite of products) or the like.

In some embodiments, glycans, such as heparan sulfate, are naturallyfound attached to a core protein (together forming a proteoglycan) or alipid. In some embodiments, provided herein are purification processesof separating glycan fragments (e.g., heparan sulfate fragments) fromproteoglycans or glycolipids prior to processing the glycan forprocessing and analysis.

Monitoring Therapy

Provided in certain embodiments are methods of treating disordersassociated with the abnormal degradation, biosynthesis and/oraccumulation of glycans, the methods comprising:

-   -   a. administering an agent for treating disorders associated with        the abnormal degradation, biosynthesis and/or accumulation of        glycans (e.g., an anti-LSD agent, an anti-cancer agent, or the        like) to an individual in need thereof;    -   b. monitoring the accumulation of glycans in the individual        using any process described herein for detecting or quantifying        the amount of glycan residual compounds (e.g., mono-saccharides,        sulfate, or the like) present in a lyase digested biological        sample (e.g., urine, serum, plasma, or CSF sample) according to        any process described herein.

Provided in further or alternative embodiments are methods of monitoringthe treatment of disorders associated with the abnormal degradation,biosynthesis and/or accumulation of glycans, the methods comprising thefollowing steps:

-   -   a. following administration of an agent for treating a disorder        associated with the abnormal degradation, biosynthesis and/or        accumulation of glycans (e.g., an anti-LSD agent, an anti-cancer        agent, or the like) to an individual in need thereof, generating        a biomarker comprising of one or more non-reducing end glycan        residual compound (e.g., monosaccharide).

In some embodiments, the biomarker is a saturated monosaccharide and isgenerated by treating a population of glycans, in or isolated from abiological sample from the individual, with at least one digestingglycan enzymes, wherein prior to enzyme treatment, the biomarker is notpresent in abundance in samples from individuals with the disease orcondition relative to individuals without the disease or condition. Incertain embodiments, monitoring of the accumulation of glycans comprisesusing an analytical instrument to detect the presence of and/or measurethe amount of the biomarker produced and displaying or recording thepresence of or a measure of a population of the biomarker; wherein thepresence of and/or measure the amount of the biomarker is utilized tomonitor the treatment.

In some embodiments, the agent is administered one or more times. Incertain embodiments, the agent is administered multiple times. In someembodiments, the agent is administered in a loading dose one or moretimes (e.g., in a loading dosing schedule) and subsequently administeredin a maintenance dose (e.g., in a maintenance dosing schedule, such asthree times a day, twice a day, once a day, once every two days, onceevery three days, once every four days, once a week, or the like). Insome embodiments, when glycan (as measure by one or more glycan residualcompound(s)) accumulation begins to increase or accelerate, the dose isoptionally adjusted (e.g., the maintenance dose is increased, or anadditional loading dose or dosing schedule is utilized).

In some embodiments, monitoring the accumulation of glycans comprisesrepeating the step of: using an analytical instrument to detect thepresence of and/or measure the amount of a population of one or moreglycan residual compounds present in a transformed biological samplethat has been prepared by treating a population of glycans, in orisolated from a biological sample from the individual, with at least onedigesting glycan lyase to transform the glycan into the population ofthe one or more glycan residual compounds. In specific embodiments, thestep is repeated at periodic intervals (e.g., every day, every otherday, every 2 days, every 3 days, every 4 days, every week, every month,every 3 months, quarterly, every 6 months, yearly, or the like), atregular times following a dose (e.g., 4 hours after a administration ofthe agent, 6 hours after administration of the agent, 8 hours afteradministration of the agent, 12 hours after administration of the agent,or the like), prior to administration of the dose (e.g., immediatelyprior to administration of the agent, 2 hours prior to administration ofthe agent, or the like), or any other monitoring schedule.

In some embodiments, the monitoring of the accumulation of glycan isconducted over a period of time, e.g., over a week, two weeks, a month,two months, three months, six months, a year, or the like. In someembodiments, the method for quantifying the amount of one or more glycanresidual compounds in a lyase digested biological sample (e.g., urine,serum, plasma, or CSF) comprises detecting and/or measuring (e.g., withan analytical device), one or more glycan residual compounds within thelyase digested biological sample from the individual after thebiological sample obtained from the individual has been treated with oneor more glycan lyases. In certain embodiments, such glycan lyases aresuitable for preparing glycan residual compounds from the glycan presentin the biological sample obtained from the individual. In certaininstances a representative portion of the one or more glycan residualcompounds in the transformed biological sample is tagged with anysuitable detectable label (e.g., a mass label, a radioisotope label, afluorescent label, a chromophore label, affinity label, an antibody). Insome embodiments, the process comprises displaying or recording such acharacterization of the population of glycan residual compounds and/ortagged glycan residual compounds.

In some embodiments, the agent described in a therapy herein includesglycan accumulation inhibitors, agents that promote glycan degradation,agents that activate enzymes that degrade glycans, agents that inhibitbiosynthesis of glycans, or the like. In some embodiments, the agentthat modulates glycan biosynthesis is an agent that selectivelymodulates heparan sulfate biosynthesis, an agent that selectivelymodulates chondroitin sulfate biosynthesis, an agent that selectivelymodulates dermatan sulfate biosynthesis, an agent that selectivelymodulates keratan sulfate biosynthesis, an agent that selectivelymodulates hyaluronan biosynthesis, or a combination thereof. Anti-LSDdrugs include, by way of non-limiting example, Imiglucerase (Cerazyme),laronidase (Aldurazyme), idursulfase (Elaprase), galsulfase (Naglazyme),agalsidase beta (Fabrazyme), alglucosidase alfa (Myozyme), agalsidasealfa (Replagal), miglustat (Zavesca).

In some embodiments, one or more of the anti-cancer agents areproapoptotic agents. Examples of anti-cancer agents include, by way ofnon-limiting example: gossyphol, genasense, polyphenol E, Chlorofusin,all trans-retinoic acid (ATRA), bryostatin, tumor necrosisfactor-related apoptosis-inducing ligand (TRAIL),5-aza-2′-deoxycytidine, all trans retinoic acid, doxorubicin,vincristine, etoposide, gemcitabine, imatinib (Gleevec®), geldanamycin,17-N-Allylamino-17-Demethoxygeldanamycin (17-AAG), flavopiridol,LY294002, bortezomib, trastuzumab, BAY 11-7082, PKC412, or PD184352,Taxol™, also referred to as “paclitaxel”, which is a well-knownanti-cancer drug which acts by enhancing and stabilizing microtubuleformation, and analogs of Taxol™, such as Taxotere™. Compounds that havethe basic taxane skeleton as a common structure feature, have also beenshown to have the ability to arrest cells in the G2-M phases due tostabilized microtubules and may be useful for treating cancer incombination with the compounds described herein.

Further examples of anti-cancer agents include inhibitors ofmitogen-activated protein kinase signaling, e.g., U0126, PD98059,PD184352, PD0325901, ARRY-142886, SB239063, SP600125, BAY 43-9006,wortmannin, or LY294002; Syk inhibitors; mTOR inhibitors; and antibodies(e.g., rituxan).

Other anti-cancer agents include Adriamycin, Dactinomycin, Bleomycin,Vinblastine, Cisplatin, acivicin; aclarubicin; acodazole hydrochloride;acronine; adozelesin; aldesleukin; altretamine; ambomycin; ametantroneacetate; aminoglutethimide; amsacrine; anastrozole; anthramycin;asparaginase; asperlin; azacitidine; azetepa; azotomycin; batimastat;benzodepa; bicalutamide; bisantrene hydrochloride; bisnafide dimesylate;bizelesin; bleomycin sulfate; brequinar sodium; bropirimine; busulfan;cactinomycin; calusterone; caracemide; carbetimer; carboplatin;carmustine; carubicin hydrochloride; carzelesin; cedefingol;chlorambucil; cirolemycin; cladribine; crisnatol mesylate;cyclophosphamide; cytarabine; dacarbazine; daunorubicin hydrochloride;decitabine; dexormaplatin; dezaguanine; dezaguanine mesylate;diaziquone; doxorubicin; doxorubicin hydrochloride; droloxifene;droloxifene citrate; dromostanolone propionate; duazomycin; edatrexate;eflornithine hydrochloride; elsamitrucin; enloplatin; enpromate;epipropidine; epirubicin hydrochloride; erbulozole; esorubicinhydrochloride; estramustine; estramustine phosphate sodium; etanidazole;etoposide; etoposide phosphate; etoprine; fadrozole hydrochloride;fazarabine; fenretinide; floxuridine; fludarabine phosphate;fluorouracil; flurocitabine; fosquidone; fostriecin sodium; gemcitabine;gemcitabine hydrochloride; hydroxyurea; idarubicin hydrochloride;ifosfamide; iimofosine; interleukin Il (including recombinantinterleukin II, or rIL2), interferon alfa-2a; interferon alfa-2b;interferon alfa-n1; interferon alfa-n3; interferon beta-1 a; interferongamma-1 b; iproplatin; irinotecan hydrochloride; lanreotide acetate;letrozole; leuprolide acetate; liarozole hydrochloride; lometrexolsodium; lomustine; losoxantrone hydrochloride; masoprocol; maytansine;mechlorethamine hydrochloride; megestrol acetate; melengestrol acetate;melphalan; menogaril; mercaptopurine; methotrexate; methotrexate sodium;metoprine; meturedepa; mitindomide; mitocarcin; mitocromin; mitogillin;mitomalcin; mitomycin; mitosper; mitotane; mitoxantrone hydrochloride;mycophenolic acid; nocodazoie; nogalamycin; ormaplatin; oxisuran;pegaspargase; peliomycin; pentamustine; peplomycin sulfate;perfosfamide; pipobroman; piposulfan; piroxantrone hydrochloride;plicamycin; plomestane; porfimer sodium; porfiromycin; prednimustine;procarbazine hydrochloride; puromycin; puromycin hydrochloride;pyrazofurin; riboprine; rogletimide; safingol; safingol hydrochloride;semustine; simtrazene; sparfosate sodium; sparsomycin; spirogermaniumhydrochloride; spiromustine; spiroplatin; streptonigrin; streptozocin;sulofenur; talisomycin; tecogalan sodium; tegafur; teloxantronehydrochloride; temoporfin; teniposide; teroxirone; testolactone;thiamiprine; thioguanine; thiotepa; tiazofurin; tirapazamine; toremifenecitrate; trestolone acetate; triciribine phosphate; trimetrexate;trimetrexate glucuronate; triptorelin; tubulozole hydrochloride; uracilmustard; uredepa; vapreotide; verteporfin; vinblastine sulfate;vincristine sulfate; vindesine; vindesine sulfate; vinepidine sulfate;vinglycinate sulfate; vinleurosine sulfate; vinorelbine tartrate;vinrosidine sulfate; vinzolidine sulfate; vorozole; zeniplatin;zinostatin; zorubicin hydrochloride.

Other anti-cancer agents include: 20-epi-1, 25 dihydroxyvitamin D3;5-ethynyluracil; abiraterone; aclarubicin; acylfulvene; adecypenol;adozelesin; aldesleukin; ALL-TK antagonists; altretamine; ambamustine;amidox; amifostine; aminolevulinic acid; amrubicin; amsacrine;anagrelide; anastrozole; andrographolide; angiogenesis inhibitors;antagonist D; antagonist G; antarelix; anti-dorsalizing morphogeneticprotein-1; antiandrogen, prostatic carcinoma; antiestrogen;antineoplaston; antisense oligonucleotides; aphidicolin glycinate;apoptosis gene modulators; apoptosis regulators; apurinic acid;ara-CDP-DL-PTBA; arginine deaminase; asulacrine; atamestane;atrimustine; axinastatin 1; axinastatin 2; axinastatin 3; azasetron;azatoxin; azatyrosine; baccatin III derivatives; balanol; batimastat;BCR/ABL antagonists; benzochlorins; benzoylstaurosporine; beta lactamderivatives; beta-alethine; betaclamycin B; betulinic acid; bFGFinhibitor; bicalutamide; bisantrene; bisaziridinylspermine; bisnafide;bistratene A; bizelesin; breflate; bropirimine; budotitane; buthioninesulfoximine; calcipotriol; calphostin C; camptothecin derivatives;canarypox IL-2; capecitabine; carboxamide-amino-triazole;carboxyamidotriazole; CaRest M3; CARN 700; cartilage derived inhibitor;carzelesin; casein kinase inhibitors (ICOS); castanospermine; cecropinB; cetrorelix; chlorins; chloroquinoxaline sulfonamide; cicaprost;cis-porphyrin; cladribine; clomifene analogues; clotrimazole;collismycin A; collismycin B; combretastatin A4; combretastatinanalogue; conagenin; crambescidin 816; crisnatol; cryptophycin 8;cryptophycin A derivatives; curacin A; cyclopentanthraquinones;cycloplatam; cypemycin; cytarabine ocfosfate; cytolytic factor;cytostatin; dacliximab; decitabine; dehydrodidemnin B; deslorelin;dexamethasone; dexifosfamide; dexrazoxane; dexverapamil; diaziquone;didemnin B; didox; diethylnorspermine; dihydro-5-azacytidine;9-dioxamycin; diphenyl spiromustine; docosanol; dolasetron;doxifluridine; droloxifene; dronabinol; duocarmycin SA; ebselen;ecomustine; edelfosine; edrecolomab; eflornithine; elemene; emitefur;epirubicin; epristeride; estramustine analogue; estrogen agonists;estrogen antagonists; etanidazole; etoposide phosphate; exemestane;fadrozole; fazarabine; fenretinide; filgrastim; finasteride;flavopiridol; flezelastine; fluasterone; fludarabine; fluorodaunorunicinhydrochloride; forfenimex; formestane; fostriecin; fotemustine;gadolinium texaphyrin; gallium nitrate; galocitabine; ganirelix;gelatinase inhibitors; gemcitabine; glutathione inhibitors; hepsulfam;heregulin; hexamethylene bisacetamide; hypericin; ibandronic acid;idarubicin; idoxifene; idramantone; ilmofosine; ilomastat;imidazoacridones; imiquimod; immunostimulant peptides; insulin-likegrowth factor-1 receptor inhibitor; interferon agonists; interferons;interleukins; iobenguane; iododoxorubicin; ipomeanol, 4-; iroplact;irsogladine; isobengazole; isohomohalicondrin B; itasetron;jasplakinolide; kahalalide F; lamellarin-N triacetate; lanreotide;leinamycin; lenograstim; lentinan sulfate; leptolstatin; letrozole;leukemia inhibiting factor; leukocyte alpha interferon;leuprolide+estrogen+progesterone; leuprorelin; levamisole; liarozole;linear polyamine analogue; lipophilic disaccharide peptide; lipophilicplatinum compounds; lissoclinamide 7; lobaplatin; lombricine;lometrexol; lonidamine; losoxantrone; lovastatin; loxoribine;lurtotecan; lutetium texaphyrin; lysofylline; lytic peptides;maitansine; mannostatin A; marimastat; masoprocol; maspin; matrilysininhibitors; matrix metalloproteinase inhibitors; menogaril; merbarone;meterelin; methioninase; metoclopramide; MIF inhibitor; mifepristone;miltefosine; mirimostim; mismatched double stranded RNA; mitoguazone;mitolactol; mitomycin analogues; mitonafide; mitotoxin fibroblast growthfactor-saporin; mitoxantrone; mofarotene; molgramostim; monoclonalantibody, human chorionic gonadotrophin; monophosphoryl lipidA+myobacterium cell wall sk; mopidamol; multiple drug resistance geneinhibitor; multiple tumor suppressor 1-based therapy; mustard anticanceragent; mycaperoxide B; mycobacterial cell wall extract; myriaporone;N-acetyldinaline; N-substituted benzamides; nafarelin; nagrestip;naloxone+pentazocine; napavin; naphterpin; nartograstim; nedaplatin;nemorubicin; neridronic acid; neutral endopeptidase; nilutamide;nisamycin; nitric oxide modulators; nitroxide antioxidant; nitrullyn;O6-benzylguanine; octreotide; okicenone; oligonucleotides; onapristone;ondansetron; ondansetron; oracin; oral cytokine inducer; ormaplatin;osaterone; oxaliplatin; oxaunomycin; palauamine; palmitoylrhizoxin;pamidronic acid; panaxytriol; panomifene; parabactin; pazelliptine;pegaspargase; peldesine; pentosan polysulfate sodium; pentostatin;pentrozole; perflubron; perfosfamide; perillyl alcohol; phenazinomycin;phenylacetate; phosphatase inhibitors; picibanil; pilocarpinehydrochloride; pirarubicin; piritrexim; placetin A; placetin B;plasminogen activator inhibitor; platinum complex; platinum compounds;platinum-triamine complex; porfimer sodium; porfiromycin; prednisone;propyl bis-acridone; prostaglandin J2; proteasome inhibitors; proteinA-based immune modulator; protein kinase C inhibitor; protein kinase Cinhibitors, microalgal; protein tyrosine phosphatase inhibitors; purinenucleoside phosphorylase inhibitors; purpurins; pyrazoloacridine;pyridoxylated hemoglobin polyoxyethylerie conjugate; raf antagonists;raltitrexed; ramosetron; ras farnesyl protein transferase inhibitors;ras inhibitors; ras-GAP inhibitor; retelliptine demethylated; rhenium Re186 etidronate; rhizoxin; ribozymes; RII retinamide; rogletimide;rohitukine; romurtide; roquinimex; rubiginone B1; ruboxyl; safingol;saintopin; SarCNU; sarcophytol A; sargramostim; Sdi 1 mimetics;semustine; senescence derived inhibitor 1; sense oligonucleotides;signal transduction inhibitors; signal transduction modulators; singlechain antigen-binding protein; sizofiran; sobuzoxane; sodiumborocaptate; sodium phenylacetate; solverol; somatomedin bindingprotein; sonermin; sparfosic acid; spicamycin D; spiromustine;splenopentin; spongistatin 1; squalamine; stem cell inhibitor; stem-celldivision inhibitors; stipiamide; stromelysin inhibitors; sulfinosine;superactive vasoactive intestinal peptide antagonist; suradista;suramin; swainsonine; synthetic glycosaminoglycans; tallimustine;tamoxifen methiodide; tauromustine; tazarotene; tecogalan sodium;tegafur; tellurapyrylium; telomerase inhibitors; temoporfin;temozolomide; teniposide; tetrachlorodecaoxide; tetrazomine;thaliblastine; thiocoraline; thrombopoietin; thrombopoietin mimetic;thymalfasin; thymopoietin receptor agonist; thymotrinan; thyroidstimulating hormone; tin ethyl etiopurpurin; tirapazamine; titanocenebichloride; topsentin; toremifene; totipotent stem cell factor;translation inhibitors; tretinoin; triacetyluridine; triciribine;trimetrexate; triptorelin; tropisetron; turosteride; tyrosine kinaseinhibitors; tyrphostins; UBC inhibitors; ubenimex; urogenitalsinus-derived growth inhibitory factor; urokinase receptor antagonists;vapreotide; variolin B; vector system, erythrocyte gene therapy;velaresol; veramine; verdins; verteporfin; vinorelbine; vinxaltine;vitaxin; vorozole; zanoterone; zeniplatin; zilascorb; and zinostatinstimalamer.

Yet other anticancer agents that include alkylating agents,antimetabolites, natural products, or hormones, e.g., nitrogen mustards(e.g., mechloroethamine, cyclophosphamide, chlorambucil, etc.), alkylsulfonates (e.g., busulfan), nitrosoureas (e.g., carmustine, lomusitne,ete.), or triazenes (decarbazine, etc.). Examples of antimetabolitesinclude but are not limited to folic acid analog (e.g., methotrexate),or pyrimidine analogs (e.g., Cytarabine), purine analogs (e.g.,mercaptopurine, thioguanine, pentostatin).

Examples of natural products include but are not limited to vincaalkaloids (e.g., vinblastin, vincristine), epipodophyllotoxins (e.g.,etoposide), antibiotics (e.g., daunorubicin, doxorubicin, bleomycin),enzymes (e.g., L-asparaginase), or biological response modifiers (e.g.,interferon alpha).

Examples of alkylating agents include, but are not limited to, nitrogenmustards (e.g., mechloroethamine, cyclophosphamide, chlorambucil,meiphalan, etc.), ethylenimine and methylmelamines (e.g.,hexamethlymelamine, thiotepa), alkyl sulfonates (e.g., busulfan),nitrosoureas (e.g., carmustine, lomusitne, semustine, streptozocin,etc.), or triazenes (decarbazine, ete.). Examples of antimetabolitesinclude, but are not limited to folic acid analog (e.g., methotrexate),or pyrimidine analogs (e.g., fluorouracil, floxouridine, Cytarabine),purine analogs (e.g., mercaptopurine, thioguanine, pentostatin.

Examples of hormones and antagonists include, but are not limited to,adrenocorticosteroids (e.g., prednisone), progestins (e.g.,hydroxyprogesterone caproate, megestrol acetate, medroxyprogesteroneacetate), estrogens (e.g., diethlystilbestrol, ethinyl estradiol),antiestrogen (e.g., tamoxifen), androgens (e.g., testosteronepropionate, fluoxymesterone), antiandrogen (e.g., flutamide),gonadotropin releasing hormone analog (e.g., leuprolide). Other agentsthat can be used in the methods and compositions described herein forthe treatment or prevention of cancer include platinum coordinationcomplexes (e.g., cisplatin, carboblatin), anthracenedione (e.g.,mitoxantrone), substituted urea (e.g., hydroxyurea), methyl hydrazinederivative (e.g., procarbazine), adrenocortical suppressant (e.g.,mitotane, aminoglutethimide).

In some instances, the detection and/or the quantification of theidentity and/or amount of glycan residual compounds present in abiological sample is used to identify and/or diagnose a disorderassociated with abnormal degradation, biosynthesis and/or accumulationof glycan in an individual suspected of having such a disorder.

In some instances, the detection and/or the quantification of theidentity and/or amount of glycan residual compounds present in thebiological sample is used to monitor severity and course of the diseasein an individual diagnosed with or suspected of having a disorderassociated with the abnormal degradation, biosynthesis and/oraccumulation of glycans. In some instances, the detection and/or thequantification of the identity and/or amount of glycan residualcompounds present in the biological sample is used to calculate theadministered dose of an agent that modulates (e.g., promotes and/orinhibits) glycan biosynthesis and/or degradation.

In certain instances, wherein following administration of a selecteddose of a therapeutic agent utilized in a therapeutic method describedherein, an individual's condition does not improve, the detection and/orthe quantification of the identity and/or amount of glycan residualcompounds present in a biological sample provides for a treatmentregimen to be modified depending on the severity and course of thedisease, disorder or condition, previous therapy, the individual'shealth status and response to the drugs, and the judgment of thetreating physician.

In certain embodiments, monitoring the accumulation of glycans in theindividual comprises detecting or quantifying the amount of an glycanresidual compounds (or one or more glycan residual compounds) in asample obtained from the individual (e.g., according to any methoddescribed herein) to obtain a first accumulation result (e.g., aninitial reading before treatment has begun, or at any other time) and asecond accumulation result that is subsequent to obtaining the firstresult. In some embodiments, the second result is compared to the firstresult to determine if the treatment is effectively reducing,maintaining, or reducing the rate of increasing the glycan residualcompounds levels in a substantially identically obtained sample from theindividual being treated. In certain embodiments, depending on thedifference between the first and second results, the treatment can bealtered, e.g., to increase or decrease the amount of agent administered;to substitute the therapeutic agent with an alternative therapeuticagent; or the like. In certain embodiments, the dose of the therapeuticagent is decreased to a maintenance level (e.g., if the glycan residualcompound level has been reduced sufficiently); further monitoring ofglycan residual compound levels is optional in such situation, e.g., toensure that reduced or maintained levels of glycan residual compounds(e.g., monosaccharide(s)) are achieved.

Alternatively, provided herein is a method of detecting response totherapy in an individual or a method of predicting response to therapyin an individual comprising:

-   -   a. administering an agent for treating a disorder associated        with the abnormal degradation, biosynthesis and/or accumulation        of glycans to a plurality of cells from an individual in need        thereof (e.g., a plurality of fibroblasts, serum, plasma, or CSF        cells from a human suffering from a disorder associated with the        abnormal degradation, biosynthesis and/or accumulation of        glycans, such as an LSD or cancer);    -   b. monitoring the accumulation of glycans in the plurality of        cells using any process described herein for detecting or        quantifying the amount of glycan residual compounds (e.g.,        monosaccharides, sulfate, sialic acid, phosphate, acetate, or        the like) present in a lyase digested biological sample from the        plurality of cells according to any process described herein.

In specific embodiments, the glycan residual compound(s) detected ormeasured is one or more monosaccharide. It is to be understood that aplurality of cells from an individual includes cells that are directlytaken from the individual, and/or cells that are taken from anindividual followed by culturing to expand the population thereof.

EXAMPLES Example 1

To illustrate the methods described herein, we have used human urinesample from normal patients and patients diagnosed with MPS IIIA. MPSIIIA patients have reduced function of the lysosomal enzyme thatde-N-sulfates the nonreducing end glucosamine residues present inheparan sulfate. This unique nonreducing end glycan residual (N-sulfatedGlcN) can be liberated by treating the glycans with heparin lyases andquantified by fluorescent detection on HPLC. As shown below, glycansprepared in this manner from normal individuals lack N-sulfate GlcNwhile MPS IIIA patients have a very high level.

Purification: The biological sample (cells, tissue, blood, serum, or thelike) is homogenized and solubilzed in 0.1-1.0 N NaOH (e.g., 0.1 N, 0.2N, 0.3 N, 0.4 N, 0.5 N, 0.6 N, 0.7 N, 0.8 N, 0.9 N, or 1.0 N) or aceticacid and then neutralized with acetic acid or NaOH. Next a small sampleis taken to measure protein content of the sample using standardmethods. 0.01-0.5 mg/mL (0.01 mg/mL, 0.07 mg/mL, 0.12 mg/mL, 0.17 mg/mL,0.22 mg/mL, 0.27 mg/mL, 0.32 mg/mL, 0.37 mg/mL, 0.42 mg/mL, or 0.5mg/mL) protease (trypsin, chymotrypsin, pepsin, pronase, papain, orelastase) is treated in 0.1-0.5 M (e.g., 0.1 M, 0.16 M, 0.23 M, 0.32 M,0.39 M, 0.44 M, or 0.5 M) NaCl, 0.01-0.1 M (e.g., 0.01 M, 0.02 M, 0.04M, 0.06 M, 0.08 M, 0.1 M) NaOAc, at pH 5.5-7.5 (e.g., 5.5, 6.0, 6.5,7.0, or 7.5) and 25-40 C (e.g., 25 C, 30 C, 35 C, or 40 C) for 1-24hours (e.g., 1 h, 2 h, 4 h, 6 h, 8 h, 12 h, 18 h, 24 h). The sample isdiluted to reduce the ionic strength and loaded onto an ion exchangecolumn in 5-100 mM (e.g., 5 mM, 10 mM, 20 mM, 30 mM, 40 mM, 50 mM, 60mM, 70 mM, 75 mM, 80 mM, 90 mM, 95 mM, 100 mM) NaOAc pH 5-7 with 0-300mM NaCl. After washing, the bound glycosaminoglycans are eluted with5-100 mM NaOAc pH 5-7 (e.g., 5, 5.5, 6, 6.5, 7) with 0.8-3 M (e.g., 0.8M, 1 M, 1.2 M, 1.4 M, 1.6 M, 1.8 M, 2 M, 2.5 M, or 3 M) NaCl. The elutedglycans are then concentrated and desalted by ethanol precipitation,size exclusion, or other methods. The purified glycans are dried forfurther analysis.

Liberation of non-reducing end residual: The purified glycans areresuspended in 10-300 mM sodium acetate, tris, phosphate, or othersuitable buffer, 0.02-1 mM (e.g., 0.02, 0.04, 0.06, 0.08, 0.1, 0.2, 0.3,0.4, 0.5, 0.6, 0.7, 0.8, 0.9, or 1) calcium acetate, pH 5-8 (e.g., 5,5.5, 6, 6.5, 7, 7.5, or 8), were digested with heparin lyases I, II,III, I and II, I and III, II and III, or I, II, and III (0.0.15-1.5milliunits of each in 100-ul reactions, IBEX, Montreal, Canada) at 25 to37° C. for 1 to 24 hours.

Fluorescent tagging of glycan residual: Dried glycan sample isre-suspended in 2-100 μL 0.003-0.1 M (e.g., 0.003 M, 0.003 M, 0.03 M,0.06 M, 0.1 M) AB, AA, AMAC, or Bodipy dye and incubated at roomtemperature for 1-120 minutes (e.g., 1-10 min, 10-15 min, 15-20 min,20-25 min, 25-30 min, 30-40 min, 40-50 min, 50-60 min, 60-90 min, 90-120min). Next, the reaction is initiated with 2-100 μL (2 μL, 5 μL, 10 μL,15 μL, 20 μL, 25 μL, 30 μL, 40 μL, 50 μL, 60 μL, 70 μL, 80 μL, 90 μL, or100 μL) 1 M NaCNBH₄ and the reaction is allowed to proceed at 25-100 C.(e.g., 25 C, 30 C, 35 C, 40 C, 50 C, 60 C, 70 C, 80 C, 90 C, 100 C).

Detection of glycan residual: HPLC separation of tagged saccharides wasperformed utilizing the following conditions: Column types: 130A BEHparticle Phenyl (1.7, 2.5, 3.5, 5, or 10 uM particle size), 130 A BEHparticle C18 (1.7, 2.5, 3.5, 5, or 10 uM particle size), HSS particleC18 (1.8, 3.5, or 5 uM particle size), or 300A BEH particle C18 (1.7,3.5, 5, 10 uM particle size) with suitable length and internal diameter.

Buffer Conditions:

-   -   A=Ammonium Acetate, Sodium Acetate, or Sodium Chloride (e.g., 0        M, 10 mM, 20 mM, 30 mM, 40 mM, 100 mM, 500 mM, 1 M, 2 M) with        0-20% methanol    -   B=100% Alcohol, such as methanol, ethanol, or isopropanol    -   Initial Conditions: 70-95% A, 0-30% B    -   Flow Rate is constant at 0.05-1 ml/min    -   Runs a gradient down to 70-90% A, 10-30% B over 5-65 min.    -   At 8.1 min runs a gradient to 0-20% A, 80-100% B over 5-20 min.    -   5-65 min returns to initial conditions

FIG. 1 illustrates an HPLC trace of eluted compounds detected in normalpatient urine not subject to enzymatic glycan residual liberation (i.e.,providing background signals). FIG. 2 illustrates an HPLC trace ofeluted compounds detected in normal patient urine subject to enzymaticglycan residual liberation as set forth in Example 1. FIG. 3 illustratesan HPLC trace of eluted compounds detected in MPS IIIA patient urine notsubject to enzymatic glycan residual liberation (i.e., providingbackground signals). FIG. 4 illustrates an HPLC trace of elutedcompounds detected in MPS IIIA patient urine subject to enzymatic glycanresidual liberation.

Example 2

The processes described in Example 1 are repeated and/or modified forthe diseases listed in Tables 1-4 utilizing the enzymes described therein and detecting the glycan residual compounds also described therein.

What is claimed is:
 1. A method of determining the presence, identity,and/or severity of a disease or condition in an individual, where thedisease or condition is associated with abnormal glycan biosynthesis,degradation, or accumulation, the method comprising: (a) generating abiomarker comprising of one or more non-reducing end glycan residualcompound(s), wherein the biomarker is generated by treating a populationof glycans, in or isolated from a biological sample from the individual,with at least one digesting glycan enzyme(s), wherein prior to enzymetreatment, the biomarker is not present in abundance in samples fromindividuals with the disease or condition relative to individualswithout the disease or condition, and (b) detecting the presence ofand/or measuring the amount of the biomarker produced using ananalytical instrument and displaying or recording the presence of or themeasure of the biomarker produced; (c) correlating the presence ofand/or the measure of the amount of the biomarker with the presence,identity, and/or severity of the disease or condition for determiningthe presence, identity, and/or severity of the disease or condition;wherein the disease or condition is a lysosomal storage disease, cancer,an inflammatory disease, a liver disease, a bone disease, an infectiousdisease, a central nervous system disease, or a cardiovascular disease;and wherein when the lysosomal storage disease is an MPS disorder orwhen the disease or condition is osteoarthritis, then the digestingglycan enzyme is not a lyase.
 2. The method of claim 1, wherein thedisease or condition is caused by an abnormally functioning glycandegradation enzyme.
 3. The method of claim 1, wherein at least one ofthe digesting glycan enzymes is selected from a sialidase,hexosaminidase, fucosidase, N-acetyl-transferase, glycosidase,sulfatase, phosphorylase, deacetylase, or a combination thereof.
 4. Themethod of claim 3, wherein at least one of the non-reducing end glycanresidual compounds is a monosaccharide or wherein at least one of thenon-reducing end glycan residual compounds is sulfate, phosphate,acetate, or a combination thereof.
 5. The method of claim 1, furthercomprising purifying the biological sample prior to enzyme treatment. 6.The method of claim 1, wherein the disease or condition associated withan abnormal glycan accumulation is MPS I, MPS II, MPS IIIA, MPS IIIB,MPS IIIC, MPS IIID, MPS IVA, MPS IVB, MPS VI, or MPS VII.
 7. The methodof claim 6, wherein the disease, condition or disorder is: (i) MPS I andat least one of the digesting glycan enzymes is an iduronidase; (ii) MPSII and at least one of the digesting glycan enzymes is a 2-sulfatase;(iii) MPS IIIA and at least one of the digesting glycan enzymes is anN-sulfatase; (iv) MPS IIIB and at least one of the digesting glycanenzymes is a hexosaminidase or a deacetylase; (v) MPS IIIC and at leastone of the digesting glycan enzymes is hexosaminidase or anN-acetyl-transferase; (vi) MPS IIID and at least one of the digestingglycan enzymes is 6-O-sulfatase; (vii) MPS IVA and at least one of thedigesting glycan enzymes is a 6-O-sulfatase, galactosidase,N-acetyl-galactosidase, or hexosaminidase; (viii) MPS IVB and at leastone of the digesting glycan enzymes is a galactosidase; (ix) MPS VI andat least one of the digesting glycan enzymes is 4-O-sulfatase; or (x)MPS VII and at least one of the digesting glycan enzymes isβ-glucuronidase.
 8. The method of claim 1, wherein the biomarker is aglycan residue and is labeled with a detectable label and the amount ofthe biomarker is measured with an analytical instrument to determinewhether the amount is abnormal.
 9. The method of claim 1, wherein thedisease, condition or disorder is alpha mannodidosis,aspartylglucoaminuria, Fabry's disease, fucosidosis, galatosialidosis,Gaucher disease, GM1 gangliosidosis, GM2 activator deficiency,sialidosis, Krabbe disease, metachromatic leukodystrophy, mucolipidosisII, mucolipidosis III, mucolipodosis IV, multiple sulfatase deficiency,Pompe disease, Sandhoff disease, Tay-Sachs disease, AB variant,Schindler disease, alpha mannosidosis, beta mannosidosis, or globoidcell leukodystrophy.
 10. The method of claim 9 wherein the disease,condition or disorder is: (i) alpha mannodidosis and at least one of thedigesting glycan enzymes is a mannosidase; (ii) aspartylglucoaminuriaand at least one of the digesting glycan enzymes is hexosaminidase;(iii) Fabry's disease and at least one of the digesting glycan enzymesis a galactosidase; (iv) fucosidosis and at least one of the digestingglycan enzymes is a fucosidase; (v) galatosialidosis and at least one ofthe digesting glycan enzymes is a galactosidase and/or a sialidase; (vi)Gaucher disease and at least one of the digesting glycan enzymes is aglucosidase; (vii) GM1 gangliosidosis and at least one of the digestingglycan enzymes is β-galactosidase; (viii) GM2 activator deficiency andat least one of the digesting glycan enzymes is hexosaminidase; (ix)sialidosis and at least one of the digesting glycan enzymes is asialidase; (x) Krabbe disease and at least one of the digesting glycanenzymes is a galactosidase; (xi) metachromatic leukodystrophy and atleast one of the digesting glycan enzymes is 3-O-sulfatase; (xii)mucolipidosis II and at least one of the digesting glycan enzymes is anylisted enzyme in Table 1; (xiii) mucolipidosis III and at least one ofthe digesting glycan enzymes is any listed enzyme in Table 1; (xiv)mucolipidosis IV and at least one of the digesting glycan enzymes is anylisted enzyme in Table 1; (xv) multiple sulfatase deficiency and atleast one of the digesting glycan enzymes is a sulfatase or glycosidase;(xvi) Pompe disease and at least one of the digesting glycan enzymes isglucosidase; (xvii) Sandhoff disease and at least one of the digestingglycan enzymes is hexosaminidase; (xviii) Tay-Sachs disease and at leastone of the digesting glycan enzymes is hexosaminidase; (xix) AB variantand at least one of the digesting glycan enzymes is hexosaminidase; (xx)Schindler disease and at least one of the digesting glycan enzymes ishexosaminidase; (xxi) alpha mannosidosis and at least one of thedigesting glycan enzymes is mannosidase; (xxii) beta mannosidosis and atleast one of the digesting glycan enzymes is mannosidase; or (xxiii)globoid cell leukodystrophy and at least one of the digesting glycanenzymes is galactosidase.
 11. The method of claim 1, wherein (i) theinfectious disease is a bacterial or fungal infection and at least oneof the digesting enzymes is a mannosidase, fucosidase, glucosidase,galactosidase, hexosaminidase, arabinosidase, xylosidase, ribosidase,lyxosidase, talosidase, idosidase, gulosidase, altrosidase, orallosidase; (ii) the infectious disease is a viral infection and atleast one of the digesting enzymes is a sialidase, α-sialidase,hexosaminidase, galactosidase, fucosidase, or sulfatase; where thedisease is coronary artery disease and at least one of the digestingenzymes is a sialidase, α-sialidase, hexosaminidase, galactosidase,fucosidase, or sulfatase; (iii) the inflammatory disease is rheumatoidarthritis, psoriatic arthritis, asthma, chronic obstructive pulmonarydisorder, lupus, hepatitis, renal disease, sickle cell disease,fibromyalgia, irritable bowel syndrome, or an ulcer and at least one ofthe digesting enzymes is a sialidase, α-sialidase, hexosaminidase,galactosidase, fucosidase, or sulfatase; or (iv) the disease isAlzheimer's disease or Parkinson's disease and at least one of thedigesting glycan enzymes is a sialidase, a hexosaminidase, agalactosidase, a fucosidase, or a sulfatase.
 12. A method monitoring thetreatment of a disorder associated with the abnormal degradation,biosynthesis and/or accumulation of glycans, the method comprising: (a)following administration of an agent for the treatment of the disorderto an individual in need thereof, using an analytical instrument tomeasure the amount of a population of a biomarker, wherein the biomarkerwas generated by treating a population of glycans, in or isolated from abiological sample from the individual to provide a transformedbiological sample, with at least one digesting glycan enzyme(s), whereinthe biomarker comprises one or more non-reducing end glycan residualcompounds present in the transformed biological sample, and whereinprior to enzyme treatment, the biomarker is not present in abundance inthe biological samples from individuals with the disorder relative toindividuals without the disorder, and (b) determining whether or not theamount of biomarker has decreased or has increased at a slower ratecompared to the amount of the biomarker or compared to the rate ofincrease, respectively, prior to administration of the agent for thetreatment of the disorder; and wherein the disorder is a lysosomalstorage disease, cancer, an inflammatory disease, a liver disease, abone disease, an infectious disease, a central nervous system disease,or a cardiovascular disease; and wherein when the disorder is an MPSdisorder or osteoarthritis, then the digesting glycan enzyme is not alyase.
 13. The method of claim 12, wherein at least one of the digestingglycan enzymes is a sialidase, hexosaminidase, fucosidase,N-acetyl-transferase, glycosidase, sulfatase, phosphorylase,deacetylase, or a combination thereof.
 14. The method of claim 12,wherein the glycan residual compound is a monosaccharide, sulfate,phosphate, acetate, or a combination thereof.
 15. The method of claim12, wherein the population of glycans is treated with a plurality ofnormally functioning glycan degradation enzymes concurrently,sequentially, or a combination thereof.
 16. The method of claim 12,wherein prior to measuring the amount of the biomarker, the biomarker islabeled with a detectable label where the detectable label is a masslabel, a radioisotope label, a fluorescent label, a chromophore label,or affinity label.
 17. The method of claim 12, wherein the disorderassociated with an abnormal glycan accumulation is MPS I, MPS II, MPSIIIA, MPS IIIB, MPS IIIC, MPS HID, MPS IVA, MPS IVB, MPS VI, or MPS VII.18. The method of claim 17, wherein the disease, condition or disorderis: (i) MPS I and at least one of the digesting glycan enzymes is aniduronidase; (ii) MPS II and at least one of the digesting glycanenzymes is a 2-sulfatase; (iii) MPS IIIA and at least one of thedigesting glycan enzymes is an N-sulfatase; (iv) MPS IIIB and at leastone of the digesting glycan enzymes is a hexosaminidase or adeacetylase; (v) MPS IIIC and at least one of the digesting glycanenzymes is hexosaminidase or an N-acetyl-transferase; (vi) MPS IIID andat least one of the digesting glycan enzymes is 6-O-sulfatase; (vii) MPSIVA and at least one of the digesting glycan enzymes is a 6-O-sulfatase,galactosidase, N-acetyl-galactosidase, or hexosaminidase; (viii) MPS IVBand at least one of the digesting glycan enzymes is a galactosidase;(ix) MPS VI and at least one of the digesting glycan enzymes is4-O-sulfatase; or (x) MPS VII and at least one of the digesting glycanenzymes is β-glucuronidase.
 19. The method of claim 12, wherein thedisease, condition or disorder is alpha mannodidosis,aspartylglucoaminuria, Fabry's disease, fucosidosis, galatosialidosis,Gaucher disease, GM1 gangliosidosis, GM2 activator deficiency,sialidosis, Krabbe disease, metachromatic leukodystrophy, mucolipidosisII, mucolipidosis III, mucolipodosis IV, multiple sulfatase deficiency,Pompe disease, Sandhoff disease, Tay-Sachs disease, AB variant,Schindler disease, alpha mannosidosis, beta mannosidosis, or globoidcell leukodystrophy.
 20. The method of claim 19 wherein the disease,condition or disorder is: (i) alpha mannodidosis and at least one of thedigesting glycan enzymes is a mannosidase; (ii) aspartylglucoaminuriaand at least one of the digesting glycan enzymes is hexosaminidase;(iii) Fabry's disease and at least one of the digesting glycan enzymesis a galactosidase; (iv) fucosidosis and at least one of the digestingglycan enzymes is a fucosidase; (v) galatosialidosis and at least one ofthe digesting glycan enzymes is a galactosidase and/or a sialidase; (vi)Gaucher disease and at least one of the digesting glycan enzymes is aglucosidase; (vii) GM 1 gangliosidosis and at least one of the digestingglycan enzymes is β-galactosidase; (viii) GM 2 activator deficiency andat least one of the digesting glycan enzymes is hexosaminidase; (ix)sialidosis and at least one of the digesting glycan enzymes is asialidase; (x) Krabbe disease and at least one of the digesting glycanenzymes is a galactosidase; (xi) metachromatic leukodystrophy and atleast one of the digesting glycan enzymes is 3-O-sulfatase; (xii)mucolipidosis II and at least one of the digesting glycan enzymes is anylisted enzyme in Table 1; (xiii) mucolipidosis III and at least one ofthe digesting glycan enzymes is any listed enzyme in Table 1; (xiv)mucolipidosis IV and at least one of the digesting glycan enzymes is anylisted enzyme in Table 1; (xv) multiple sulfatase deficiency and atleast one of the digesting glycan enzymes is a sulfatase or glycosidase;(xvi) Pompe disease and at least one of the digesting glycan enzymes isglucosidase; (xvii) Sandhoff disease and at least one of the digestingglycan enzymes is hexosaminidase; (xviii) Tay-Sachs disease and at leastone of the digesting glycan enzymes is hexosaminidase; (xix) AB variantand at least one of the digesting glycan enzymes is hexosaminidase; (xx)Schindler disease and at least one of the digesting glycan enzymes ishexosaminidase; (xxi) alpha mannosidosis and at least one of thedigesting glycan enzymes is mannosidase; (xxii) beta mannosidosis and atleast one of the digesting glycan enzymes is mannosidase; or (xxiii)globoid cell leukodystrophy and at least one of the digesting glycanenzymes is galactosidase.
 21. The method of claim 12, wherein (i) theinfectious disease is a bacterial or fungal infection and at least oneof the digesting enzymes is a mannosidase, fucosidase, glucosidase,galactosidase, hexosaminidase, arabinosidase, xylosidase, ribosidase,lyxosidase, talosidase, idosidase, gulosidase, altrosidase, orallosidase; (ii) the infectious disease is a viral infection and atleast one of the digesting enzymes is a sialidase, α-sialidase,hexosaminidase, galactosidase, fucosidase, or sulfatase; where thedisease is coronary artery disease and at least one of the digestingenzymes is a sialidase, α-sialidase, hexosaminidase, galactosidase,fucosidase, or sulfatase; (iii) the inflammatory disease is rheumatoidarthritis, psoriatic arthritis, asthma, chronic obstructive pulmonarydisorder, lupus, hepatitis, renal disease, sickle cell disease,fibromyalgia, irritable bowel syndrome, or an ulcer and at least one ofthe digesting enzymes is a sialidase, α-sialidase, hexosaminidase,galactosidase, fucosidase, or sulfatase; or (iv) the disease isAlzheimer's disease or Parkinson's disease and at least one of thedigesting glycan enzymes is a sialidase, a hexosaminidase, agalactosidase, a fucosidase, or a sulfatase.